Abstract 4146172: Gender Differences in Outcomes of Leukemia Patients Undergoing Transcatheter Aortic Valve Implantation (TAVI): An Analysis of National Inpatient Sample (NIS) Data from 2016-2021

Background: Transcatheter Aortic Valve Implantation (TAVI) is increasingly used to treat severe aortic stenosis in patients who are at high risk for conventional surgery. Patients with leukemia represent a unique subset, often presenting with additional comorbidities and a higher susceptibility to complications. Gender differences in clinical outcomes following TAVI in leukemia patients remain under-explored. Understanding these differences is crucial for optimizing patient care and improving procedural outcomes in this vulnerable population. Methods: A retrospective analysis using the National Inpatient Sample (NIS) data from 2016 to 2021 compared male and female leukemia patients undergoing TAVI. Multivariate logistic regression was utilized to analyze variables such as in-hospital mortality, transfusion requirements, bleeding, and other complications. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and statistical significance was determined by P-values. Results: The study included 2,175 male and 1,055 female leukemia patients undergoing TAVI. The majority of patients were White, with 91.92% of males and 92.12% of females. Black patients constituted 2.14% of the male and 2.46% of the female groups.The mean age of male patients was 79.25 years, while female patients were slightly older, with a mean age of 80.66 years. Total charges were comparable between genders, with males incurring $217,554.6 and females $224,248.3. The length of stay was also similar, with males staying an average of 3.48 days and females 3.82 days. Mortality was significantly higher in females compared to males, with an odds ratio (OR) of 8.824 (95% CI: 1.415-55.017, P=0.02). Females also had higher odds of requiring transfusions (OR=2.049, 95% CI: 1.052-3.989, P=0.035) and experiencing bleeding complications (OR=2.039, 95% CI: 1.17-3.555, P=0.012). Other complications, such as vascular injury, permanent pacemaker (PPM) insertion, arrhythmias, and respiratory failure, did not show significant gender differences. Conclusion: Female leukemia patients undergoing TAVI are at a significantly higher risk of mortality, requiring more transfusions, and experiencing increased bleeding compared to their male counterparts. These findings underscore the urgent need for gender-specific management strategies and further research to enhance outcomes for this high-risk population.