Abbonarsi

National trends and 30-day readmission rates for next-day-discharge transcatheter aortic valve replacement: An analysis from the Nationwide Readmissions Database, 2012-2016 - 18/12/20

Doi : 10.1016/j.ahj.2020.08.015 
Charan Yerasi, MD a, Byomesh Tripathi, MD b, Yanying Wang, PhD a, Brian J. Forrestal, MD a, Brian C. Case, MD a, Jaffar M. Khan, BM BCh a, Rebecca Torguson, MPH a, Itsik Ben-Dor, MD a, Lowell F. Satler, MD a, Hector M. Garcia-Garcia, MD, PhD a, William S. Weintraub, MD a, Toby Rogers, MD, PhD a, c, Ron Waksman, MD a,
a Section of Interventional Cardiology, Medstar Washington Hospital Center, Washington, DC 
b University of Arizona-College of Medicine, Phoenix, AZ 
c Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 

Reprint requests: Ron Waksman, MD, Professor of Medicine, Georgetown University, Associate Director of Cardiology, Director of Cardiovascular Research and Advanced Education, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, 110 Irving St, NW, Suite 4B-1, Washington, DC 20010.Georgetown UniversityAssociate Director of Cardiology, Director of Cardiovascular Research and Advanced Education, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, 110 Irving St, NW, Suite 4B-1WashingtonDC20010

Background

Transcatheter aortic valve replacement (TAVR) has evolved toward a minimalist approach, resulting in shorter hospital stays. Real-world trends of next-day discharge (NDD) TAVR are unknown. This study aimed to evaluate underlying trends and readmissions of NDD TAVR.

Methods

This study was derived from the Nationwide Readmissions Database from 2012 to 2016. International Classification of Diseases, Ninth and Tenth Revisions, codes were used to identify patients. Any discharge within 1 day of admission was identified as NDD. NDD TAVR trends over the years were analyzed, and any admissions within 30 days were considered readmissions. A hierarchical logistic regression model was used to identify predictors of readmission.

Results

Of 49,742 TAVR procedures, 3,104 were NDD. The percentage of NDD TAVR increased from 1.5% (46/3,051) in 2012 to 12.2% (2,393/19,613) in 2016. However, the 30-day readmission rate remained the same over the years (8.6%). The patients' mean age was 80.3 ± 8.4 years. Major readmission causes were heart-failure exacerbation (16%), infections (9%), and procedural complications (8%). In 2016, there were significantly higher late conduction disorder and gastrointestinal bleeding readmission rates than in 2012-2015. Significant predictors of readmission were anemia, baseline conduction disease, cardiac arrhythmias, heart failure, chronic kidney disease, chronic obstructive pulmonary disease, neoplastic disorders, and discharge to facility.

Conclusions

The percentage of NDD TAVR increased over the years; however, readmission rates remained the same, with a higher rate of conduction abnormality–related hospitalizations in 2016. Careful discharge planning that includes identification of baseline factors that predict readmission and knowledge of etiologies may further prevent 30-day readmissions.

Il testo completo di questo articolo è disponibile in PDF.

Graphical abstract

Trends, readmission rates, and etiologies of readmission for next-day discharge TAVR from 2012 to 2016. *Unweighted estimates. NDD, next-day discharge; TAVR, transcatheter aortic valve replacement; LOS, length of stay.



Unlabelled Image

Il testo completo di questo articolo è disponibile in PDF.

Mappa


© 2020  Elsevier Inc. Tutti i diritti riservati.
Aggiungere alla mia biblioteca Togliere dalla mia biblioteca Stampare
Esportazione

    Citazioni Export

  • File

  • Contenuto

Vol 231

P. 25-31 - Gennaio 2021 Ritorno al numero
Articolo precedente Articolo precedente
  • Association between levosimendan, postoperative AKI, and mortality in cardiac surgery: Insights from the LEVO-CTS trial
  • Oliver K. Jawitz, Amanda S. Stebbins, Vignesh Raman, Brooke Alhanti, Sean van Diepen, Matthias Heringlake, Stephen Fremes, Richard Whitlock, Steven R. Meyer, Rajendra H. Mehta, Mark Stafford-Smith, Shaun G. Goodman, John H. Alexander, Renato D. Lopes
| Articolo seguente Articolo seguente
  • Statins and atherosclerotic cardiovascular outcomes in patients on incident dialysis and with atherosclerotic heart disease
  • Jay S. Shavadia, Jonathan Wilson, Daniel Edmonston, Alyssa Platt, Patti Ephraim, Rasheeda Hall, Benjamin A. Goldstein, L. Ebony Boulware, Eric Peterson, Jane Pendergast, Julia J. Scialla

Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.

Già abbonato a @@106933@@ rivista ?

Il mio account


Dichiarazione CNIL

EM-CONSULTE.COM è registrato presso la CNIL, dichiarazione n. 1286925.

Ai sensi della legge n. 78-17 del 6 gennaio 1978 sull'informatica, sui file e sulle libertà, Lei puo' esercitare i diritti di opposizione (art.26 della legge), di accesso (art.34 a 38 Legge), e di rettifica (art.36 della legge) per i dati che La riguardano. Lei puo' cosi chiedere che siano rettificati, compeltati, chiariti, aggiornati o cancellati i suoi dati personali inesati, incompleti, equivoci, obsoleti o la cui raccolta o di uso o di conservazione sono vietati.
Le informazioni relative ai visitatori del nostro sito, compresa la loro identità, sono confidenziali.
Il responsabile del sito si impegna sull'onore a rispettare le condizioni legali di confidenzialità applicabili in Francia e a non divulgare tali informazioni a terzi.


Tutto il contenuto di questo sito: Copyright © 2024 Elsevier, i suoi licenziatari e contributori. Tutti i diritti sono riservati. Inclusi diritti per estrazione di testo e di dati, addestramento dell’intelligenza artificiale, e tecnologie simili. Per tutto il contenuto ‘open access’ sono applicati i termini della licenza Creative Commons.