Trends in mortality among the geriatric population undergo-ing Surgical aortic valve replacement(SAVR)and potential ra-cial disparities:a 20-year perspective via the National(Nati-onwide)Inpatient SampleOA

Background Racial disparities in cardiovascular conditions are well documented.Whether similar race-based discrepancies in heal-th outcomes also exist among elderly patients undergoing surgical aortic valve replacement(SAVR)for aortic stenosis remains understudied. Methods We abstracted data from the National(Nationwide)Inpatient Sample over a 20-year period from 2001 to 2020 using specific ICD-9 and ICD-10 codes.We included patients aged ≥ 60 and ≤ 80 years with races recorded as White,African American,or Hispanic at the time of their hospitalization for surgery.We analyzed and reported the baseline characteristics,risk-adjusted in-hospital mortality,and complications stratified by race. Results Of 420,181 patients studied,90.0％identified as White,4.0％as African American and 6.0％as Hispanic.Despite a de-crease in overall in-hospital mortality rates from 3.8％between 2001-2005 to 1.8％between 2016-2020,African Americans had higher odds of all-cause in-hospital deaths compared to Whites(aOR=1.390,P＜0.001).Additionally,they were more likely to experi-ence cardiogenic shock(aOR=1.241,P＜0.001)and acute kidney injury(aOR=1.314,P＜0.001)as well as more likely to require organ support such as IABP use(aOR=1.336,P＜0.001)or invasive mechanical ventilation(aOR=1.342,P＜0.001).Interestingly,African Americans were less likely to report events of acute ischemic stroke compared to Whites(aOR=0.852,P＜0.001). Conclusions Despite a reassuring reduction in overall in-hospital mortality rates of geriatric patients undergoing SAVR for aor-tic stenosis,racial disparities in health outcomes remain pervasive with minorities more likely to report higher in-hospital mor-bidity and mortality.