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In the mild/moderate SOI group, the vast majority (>60%) of patients were discharged, even in the ��80-year-old group home. Conversely, in the extreme SOI group, a minority of patients in the ��80-year-old group (>25%) were discharged home. Figure 2 Discharge home by Severity of comorbid illness (SOI) by age. Resource utilization Median in-hospital costs in the mild/moderate, major, and Selleckchem Forskolin extreme SOI strata were ��29,202.08, ��36,035.13, and ��57,572.92, respectively. Figures 3 and ?and44 illustrate that within the mild/moderate and major SOI strata, LOS and cost increase significantly (P mortality is similar to other recently published series, including a recent study from the Society of Thoracic Surgeons (STS) database reporting an inpatient mortality of 2.6% for AVR in 2006.5 In a similar analysis of the NIS, Astor et al7 reported a 4.5% mortality for patients undergoing AVR in 1994, thus providing additional data to suggest that outcomes in patients undergoing surgical AVR are improving measurably over Sitaxentan time. Mild, moderate, and major severity of comorbid illness This analysis provides further evidence that isolated surgical AVR provides excellent outcomes in well-selected patients regardless of age.5,6,8 Among patients in the mild/moderate and major SOI strata (which includes 85% of the total study population), in-hospital mortality for the entire study population was 0.35% and 1.51%, respectively. Though in-hospital mortality was threefold to fourfold higher in the ��80-year-old group compared with those aged CX-5461 supplier than 2% among mild/moderate/major SOI across all age strata. Furthermore, more than 50% of ��80-year-old patients were discharged home (Figure 2). Finally, though total inpatient costs increased significantly with increasing age, the absolute differences were relatively small (Figure 4). Notably, median total in-hospital costs in the mild/moderate stratum are less than the cost of a transcatheter aortic valve device alone. These findings suggest that surgical AVR should remain the gold standard for treatment across a large proportion of patients with isolated AS.