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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 [http://www.selleckchem.com/products/forskolin.html buy 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 [http://www.selleckchem.com/products/cx-5461.html CX-5461] 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 [https://en.wikipedia.org/wiki/Sitaxentan Sitaxentan] 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.