Rating Explanations

The TAVR 30-day morbidity/mortality composite was developed by a TVT Registry Workgroup (physician leaders of the registry and statisticians at Duke Clinical Research Institute) for the purpose of providing feedback in the institutional outcomes reports. The model is a hierarchical, multi-category risk model that estimates risk standardized results (reported as a “site difference” and including the calculation of 1-3 stars for public reporting) for 5 endpoints (outcomes) at 30 days (mortality, stroke, major or life threatening bleeding, acute kidney injury, or moderate-severe paravalvular aortic regurgitation leakage around the new heart valve). If a patient experiences multiple outcomes, the outcome with the highest rank is assigned. The model includes 46 variables including KCCQ and gait speed (5-meter walk) and is reported on rolling 3 years of data (not R4Q).

Please click on the hyperlink to learn more about the National Quality Forum endorsed TAVR 30-day morbidity/mortality composite measure. Please click here for the Public Reporting Companion Guide.

    1. 30-Day Risk Adjusted TAVR Composite consists of six ordered categories based on the worst possible outcome (30-day death) to the best possible outcome (e.g. alive and free of major complications) during hospitalization and the 30-day follow-up period as defined below:
      1. 30-day death
      2. 30-day stroke
      3. 30-day life-threatening/major bleed
      4. Acute kidney injury (stage Ill)
      5. 30-day moderate to severe paravalvular leakage around the new heart valve
      6. None of the above
    2. The TAVR 30-day mortality/morbidity composite score is reported as a "win difference” where:
      • >0 implies "My Hospital" has better than expected performance, and
      • <0 implies "My Hospital" has worse than expected performance
    3. Missing value (-) indicates that the hospital does not meet eligibility criteria for reporting