Key result
Early discharge post-TAVR cuts stroke risk ~83% alongside fewer vascular, bleeding, and pacemaker implantations.
Why the study?
Minimalist approaches are being developed to provide early discharge after TAVR as a potentially viable option to reduce hospital stay and costs, motivating a comparison of clinical outcomes between early and late discharge.
Does early discharge (< 3 days) improve clinical outcomes and safety in patients undergoing TAVR?
Does early discharge (< 3 days) improve clinical outcomes and safety in patients undergoing TAVR?
Early discharge (< 3 days) after TAVR appears safe and is associated with lower risks of stroke, vascular complications, bleeding, and pacemaker implantation compared to late discharge.
Early discharge after TAVR links to fewer complications with comparable mortality; extends low-certainty observational data but requires RCTs before practice change.
Background With the rise of TAVR, "minimalist" approaches are being developed to provide early discharge after TAVR as a potentially viable option. Early discharge (< 3 days) after TAVR reduces the length of hospital stay, reduces hospitalization costs, and may mitigate the risk of nosocomial infection. Purpose This systematic review and meta-analysis aimed to compare clinical outcomes with early versus late discharge post-TAVR. Methods A systematic literature search on PubMed, Embase, and the Cochrane Library was performed to retrieve relevant studies. Pooled risk ratios (RR) with 95% CIs were calculated using a random-effects model, with a p-value of <0.05 considered statistically significant. Results 13 studies with 1,42,564 patients undergoing TAVR (62,658: early discharge; 79,906: late discharge) were included. Early discharge for patients post-TAVR was associated with a statistically significant reduced risk of stroke [RR: 0.17; 95% CI: 0.11, 0.27; p<0.00001], vascular complications [RR: 0.28; 95% CI: 0.17, 0.45; p<0.00001], bleeding complications [RR: 0.43; 95% CI: 0.37, 0.50; p<0.00001], and new permanent pacemaker implantation [RR: 0.37; 95% CI: 0.28, 0.49; p<0.00001] compared to patients with late discharge. The risks of all-cause mortality [RR: 1.39; 95% CI: 0.62, 3.11] and readmission [RR: 0.75; 95% CI: 0.50, 1.13] were comparable between the two groups. Conclusion Early discharge after TAVR is associated with lower risks of stroke, readmission, vascular complications, and bleeding complications than late discharge (> 3 days). This meta-analysis concludes the safety of early discharge following TAVR.Figure 1
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Jain et al. (2025) studied this question. Early discharge (<3 days) after TAVR significantly reduced stroke risk (RR 0.17), vascular (RR 0.28), bleeding (RR 0.43), and pacemaker implantation (RR 0.37) versus late discharge.
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