Hospital readmissions after TAVI for heart failure, infection, stroke, and fracture were all significantly associated with increased all-cause mortality (e.g., heart failure HR 5.54; 95% CI 3.99-7.69).
Cohort (n=1,008)
Are cause-specific hospital readmissions (heart failure, infection, fracture, stroke) associated with increased long-term all-cause mortality in patients who have undergone TAVI?
Both cardiac and non-cardiac hospital readmissions following TAVI are strongly associated with a 4- to 5-fold increased risk of long-term all-cause mortality.
Estimación del efecto: HR 5.54 (for heart failure) (95% CI 3.99-7.69)
valor p: p=<0.01
Hospital readmissions after transcatheter aortic valve implantation (TAVI) are common, yet the long-term impact of both readmission for heart failure and non-cardiac readmissions, including infection, fracture, and stroke, on mortality remains insufficiently understood. This retrospective cohort study included 1,008 patients (mean age 85 ± 5 years; 325 32% male) who underwent TAVI between January 2014 and December 2024. Cardiac readmission was defined as readmission for heart failure, whereas non-cardiac readmissions were defined as those due to infection, fracture, and stroke. Cause-specific cumulative incidence functions were estimated using the Fine–Gray model, with death treated as a competing risk, and the associations between each type of readmission and all-cause mortality were evaluated using time-dependent Cox proportional hazards models. During the observation period, 253 patients (26%) died. The 10-year cumulative incidence rates were 38% for heart failure, 10% for infection, 23% for fracture, and 9% for stroke. Although infection-, fracture-, and stroke-related readmissions occurred less frequently than mortality as a competing risk, all were significantly associated with increased all-cause mortality: heart failure (HR 5.54, 95% CI 3.99–7.69), infection (HR 5.00, 95% CI 2.81–8.89), stroke (HR 5.69, 95% CI 3.39–9.54), and fracture (HR 4.47, 95% CI 2.90–6.09) (all p < 0.01). Most readmissions occurred within the first year, while fracture-related readmissions showed a secondary rise around the second year, and all event types increased again after the third year. Hospital readmissions following TAVI, including both cardiac and non-cardiac causes, were significantly associated with increased all-cause mortality.
Naito et al. (Mon,) conducted a cohort in Post-transcatheter aortic valve implantation (TAVI) (n=1,008). Cause-specific hospital readmission (heart failure, infection, fracture, stroke) vs. No readmission was evaluated on All-cause mortality (HR 5.54 (for heart failure), 95% CI 3.99-7.69, p=<0.01). Hospital readmissions after TAVI for heart failure, infection, stroke, and fracture were all significantly associated with increased all-cause mortality (e.g., heart failure HR 5.54; 95% CI 3.99-7.69).