{"id":4632,"date":"2018-03-06T00:00:00","date_gmt":"2018-03-06T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\/"},"modified":"2023-06-14T19:50:42","modified_gmt":"2023-06-14T23:50:42","slug":"temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\/","title":{"rendered":"Temporal trends and clinical consequences of wait-times for trans-catheter aortic valve replacement: a population based study"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; Trans-catheter aortic valve replacement (TAVR) represents a paradigm shift in the therapeutic options for patients with severe aortic stenosis. However, rapid and exponential growth in TAVR demand may overwhelm capacity, translating to inadequate access and prolonged wait times. Our objective was to evaluate temporal trends in TAVR wait times and the associated clinical consequences. <\/p>\n<p><strong>Methods<\/strong> &#x2014; In this population-based study in Ontario, Canada, we identified all TAVR referrals from April 1, 2010 to March 31, 2016. The primary outcome was the median total wait time from referral to procedure. Piecewise regression analyses were performed to assess temporal trends in TAVR wait times, before and after provincial reimbursement in September 2012. Clinical outcomes included all-cause death and heart failure hospitalizations while on the wait list.<\/p>\n<p><strong>Results<\/strong> &#x2014; The study cohort included 4461 referrals, of which 50% led to a TAVR, 39% were off-listed for other reasons, and 11% remained on the wait list at the conclusion of the study. For patients who underwent a TAVR, the estimated median wait time in the postreimbursement period stabilized at 80 days and has remained unchanged. The cumulative probability of wait-list mortality and heart failure hospitalization at 80 days was &#x2248;2% and 12%, respectively, with a relatively constant increase in events with increased wait times.<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; Postreimbursement wait time has remained unchanged for patients undergoing a TAVR procedure, suggesting the increase in capacity has kept pace with the increase in demand. The current wait time of almost 3 months is associated with important morbidity and mortality, suggesting a need for greater capacity and access.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; Trans-catheter aortic valve replacement (TAVR) represents a paradigm shift in the therapeutic options for patients with severe aortic stenosis. However, rapid and exponential growth in TAVR demand may overwhelm capacity, translating to inadequate access and prolonged wait times. Our objective was to evaluate temporal trends in TAVR wait times and the associated clinical [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-4632","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Elbaz-Greener G, Masih S, Fang J, Ko DT, Lauck SB, Webb JG, Nallamothu BK, Wijeysundera HC. <em>Circulation<\/em>. 2018; 138(5):483-93. Epub 2018 Mar 6.","source_url":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.117.033432","ices_scientist":[1146,1133],"site":[6733],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"D7657C76-0F21-4A70-930E-943D0D80AD7F","sitecore_item_name":"Temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement","sitecore_field_values":"{\n  \"Title\": \"Temporal trends and clinical consequences of wait-times for trans-catheter aortic valve replacement: a population based study\",\n  \"Short title\": \"Temporal trends and clinical\",\n  \"Summary\": \"The study objective was to evaluate temporal trends in TAVR wait-times and the associated clinical consequences.\",\n  \"Citation\": \"<p>Elbaz-Greener G, Masih S, Fang J, Ko DT, Lauck SB, Webb JG, Nallamothu BK, Wijeysundera HC. <em>Circulation<\/em>. 2018; 138(5):483-93. Epub 2018 Mar 6.<\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; Trans-catheter aortic valve replacement (TAVR) represents a paradigm shift in the therapeutic options for patients with severe aortic stenosis. However, rapid and exponential growth in TAVR demand may overwhelm capacity, translating to inadequate access and prolonged wait times. Our objective was to evaluate temporal trends in TAVR wait times and the associated clinical consequences. <\/p>n<p><strong>Methods<\/strong> &mdash; In this population-based study in Ontario, Canada, we identified all TAVR referrals from April 1, 2010 to March 31, 2016. The primary outcome was the median total wait time from referral to procedure. Piecewise regression analyses were performed to assess temporal trends in TAVR wait times, before and after provincial reimbursement in September 2012. Clinical outcomes included all-cause death and heart failure hospitalizations while on the wait list.<\/p>n<p><strong>Results<\/strong> &mdash; The study cohort included 4461 referrals, of which 50% led to a TAVR, 39% were off-listed for other reasons, and 11% remained on the wait list at the conclusion of the study. For patients who underwent a TAVR, the estimated median wait time in the postreimbursement period stabilized at 80 days and has remained unchanged. The cumulative probability of wait-list mortality and heart failure hospitalization at 80 days was &asymp;2% and 12%, respectively, with a relatively constant increase in events with increased wait times.<\/p>n<p><strong>Conclusions<\/strong> &mdash; Postreimbursement wait time has remained unchanged for patients undergoing a TAVR procedure, suggesting the increase in capacity has kept pace with the increase in demand. The current wait time of almost 3 months is associated with important morbidity and mortality, suggesting a need for greater capacity and access.<\/p>n<p><a href=\"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.117.033432\" title=\"opens external link\">View full text<\/a><\/p>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{B3827152-93D1-4FB2-B106-590CB331A264}|{8C2597F4-2B41-4E87-9F28-6887C689651B}\",\n  \"Posted Date\": \"20180306T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2018\/March\/Temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Temporal trends and clinical consequences of wait-times for trans-catheter aortic valve replacement: a population based study<\/title>\n<meta name=\"description\" content=\"Background &#x2014; Trans-catheter aortic valve replacement (TAVR) represents a paradigm shift in the therapeutic options for patients with severe aortic\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Temporal trends and clinical consequences of wait-times for trans-catheter aortic valve replacement: a population based study\" \/>\n<meta property=\"og:description\" content=\"Background &#x2014; Trans-catheter aortic valve replacement (TAVR) represents a paradigm shift in the therapeutic options for patients with severe aortic\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:50:42+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\\\/\",\"name\":\"ICES | Temporal trends and clinical consequences of wait-times for trans-catheter aortic valve replacement: a population based study\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2018-03-06T05:00:00+00:00\",\"dateModified\":\"2023-06-14T23:50:42+00:00\",\"description\":\"Background &#x2014; Trans-catheter aortic valve replacement (TAVR) represents a paradigm shift in the therapeutic options for patients with severe aortic\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Journal Articles\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Temporal trends and clinical consequences of wait-times for trans-catheter aortic valve replacement: a population based study\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"name\":\"ICES\",\"description\":\"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE\",\"publisher\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\"},\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\",\"name\":\"ICES\",\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"contentUrl\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"width\":\"676\",\"height\":\"618\",\"caption\":\"ICES\"},\"image\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/ICESOntario\\\/\",\"https:\\\/\\\/www.linkedin.com\\\/company\\\/ices-research-institute\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"ICES | Temporal trends and clinical consequences of wait-times for trans-catheter aortic valve replacement: a population based study","description":"Background &#x2014; Trans-catheter aortic valve replacement (TAVR) represents a paradigm shift in the therapeutic options for patients with severe aortic","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\/","og_locale":"fr_FR","og_type":"article","og_title":"ICES | Temporal trends and clinical consequences of wait-times for trans-catheter aortic valve replacement: a population based study","og_description":"Background &#x2014; Trans-catheter aortic valve replacement (TAVR) represents a paradigm shift in the therapeutic options for patients with severe aortic","og_url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\/","og_site_name":"ICES","article_publisher":"https:\/\/www.facebook.com\/ICESOntario\/","article_modified_time":"2023-06-14T23:50:42+00:00","og_image":[{"width":1200,"height":675,"url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\/","url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\/","name":"ICES | Temporal trends and clinical consequences of wait-times for trans-catheter aortic valve replacement: a population based study","isPartOf":{"@id":"https:\/\/www.ices.on.ca\/fr\/#website"},"datePublished":"2018-03-06T05:00:00+00:00","dateModified":"2023-06-14T23:50:42+00:00","description":"Background &#x2014; Trans-catheter aortic valve replacement (TAVR) represents a paradigm shift in the therapeutic options for patients with severe aortic","breadcrumb":{"@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/temporal-trends-and-clinical-consequences-of-wait-times-for-trans-catheter-aortic-valve-replacement-a-population-based-study\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.ices.on.ca\/fr\/"},{"@type":"ListItem","position":2,"name":"Journal Articles","item":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/"},{"@type":"ListItem","position":3,"name":"Temporal trends and clinical consequences of wait-times for trans-catheter aortic valve replacement: a population based study"}]},{"@type":"WebSite","@id":"https:\/\/www.ices.on.ca\/fr\/#website","url":"https:\/\/www.ices.on.ca\/fr\/","name":"ICES","description":"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE","publisher":{"@id":"https:\/\/www.ices.on.ca\/fr\/#organization"},"alternateName":"Institute for Clinical Evaluative Sciences","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.ices.on.ca\/fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/www.ices.on.ca\/fr\/#organization","name":"ICES","alternateName":"Institute for Clinical Evaluative Sciences","url":"https:\/\/www.ices.on.ca\/fr\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/","url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","contentUrl":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","width":"676","height":"618","caption":"ICES"},"image":{"@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/ICESOntario\/","https:\/\/www.linkedin.com\/company\/ices-research-institute\/"]}]}},"_links":{"self":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article\/4632","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article"}],"about":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/types\/journal_article"}],"acf:post":[{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/research_program\/6742"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/site\/6733"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1133"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1146"}],"wp:attachment":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/media?parent=4632"}],"wp:term":[{"taxonomy":"migration-helper-automated","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-automated?post=4632"},{"taxonomy":"migration-manual","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-manual?post=4632"},{"taxonomy":"topic","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/topic?post=4632"},{"taxonomy":"migration-helper-qa-sample-set","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-qa-sample-set?post=4632"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}