Readmissions are frequent after cardiovascular procedures and they significantly increase healthcare costs. Data on readmission need within the first month after successful transcatheter aortic valve replacement (TAVR) are limited.
The registry included all TAVR patients surviving index hospitalization between January and February 2013 for readmission incidence, predictors, causes and costs within 30 days.
Of 12,221 included patients, 2,188 (17.9%) required readmission within 30 days.
Readmission predictors were:
- length of stay longer than 5 days during index hospitalization
- kidney injury (both acute and chronic)
- transapical access
- chronic lung disease
61.8% of these was due to non-cardiac causes and the remaining 38.2% was due to cardiac causes. Respiratory causes (14.7%), infections (12.8%), bleeding (7.6%) and peripheral vascular disease (4.3%) were the most common among non-cardiac causes, while heart failure (22.5%) and arrhythmia was the most common among cardiac causes (6.6%).
Readmissions median length was four more days.
Conclusion
Readmissions at 30 days after TAVR are frequent and are associated with comorbidities, access site and complications during index hospitalization. These predictors could alert about patients at high risk of readmission and prevent major complications.
Original Title: Thirty-Day Readmissions after Transcatheter Aortic Valve Replacement in the United States. Insights from the Nationwide Readmissions Database.
Reference: Dhaval Kolte et al. Circ Cardiovasc Interv. 2017 Jan;10(1).
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