OBJECTIVES: To examine the healthcare burden of commercially insured patients 12 months following onset of severe tricuspid regurgitation (STR).

METHODS: Data were obtained from the Optum^® Integrated Database [Electronic health records (EHR) and Claims] from 2016-2022Q1. Eligible patients met the following inclusion criteria: age ≥ 18 with a ICD10 diagnosis of Tricuspid Regurgitation, physician note indicating STR and a record of an echocardiogram within 30 days. Additionally, patients had to have a heart failure hospitalization or at least three of the following signs or symptoms identified by NLP algorithm, ICD code or lab value: kidney or liver disfunction, right ventricular dysfunction, weight loss, insomnia, ascites, or elevated jugular veins. Time zero was the date of their heart failure hospitalization or the date of the third sign or symptom. Patients were required to have 6 months of continuous claims and prescription coverage prior to time zero; patients were excluded if they had a prior tricuspid valve intervention, end stage renal disease, severe mitral regurgitation, or a record of cardiac surgery 3 months prior to time zero. Outcomes of interest were death, all-cause hospitalizations, hospital days, emergency department, outpatient and office visits and annualized costs.

RESULTS: The study cohort consisted of 136 patients with recent onset STR. The mean age was 77 years, 65% were female, and the mean Elixhauser comorbidity index was 7.6. All-cause mortality was 40% at 6 months and 48% at 1 year. Annualized average (SD) all cause hospitalizations and hospital days were as follows: 2.64 (5.46) and 15.95 (27.90). Annualized emergency department, outpatient and office visits were 1.13 (3.38), 8.94 (13.08) and 13.36 (14.40) respectively. Annualized costs in the 12 months following severe TR onset were $95,692 ($110,866).

CONCLUSIONS: Severe TR is associated with a high rate of mortality as well as substantial resource utilization and healthcare-related costs.