Hospital Practice of Direct‐Home Discharge and 30‐Day Readmission After Transcatheter Aortic Valve Replacement in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) Registry

Figures

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  Figure 1. Cohort flow diagram. CMS indicates Centers for Medicare & Medicaid Services; n/a, not available; TAVR, transcatheter aortic valve replacement; TVT, transcatheter valve therapy.

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  Figure 2. Distribution of direct‐home discharge among hospitals. Shown is the distribution of hospitals (N=329) based on the proportion of patients discharged directly home post‐TAVR. The median percentage direct‐home discharge rate among hospitals was 72.2%. TAVR indicates transcatheter aortic valve replacement.

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  Figure 3. Association of US region with practice of discharge to skilled nursing facility. Shown are the 30‐day direct discharge home rates by state. Overall, the lowest rates of direct home discharge were in the Northeast United States.

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  Figure 4. Thirty‐day readmission rates by quartile of direct home discharge. Shown are 30‐day readmission rates (median, interquartile range) for each category of direct discharge home (quartile 1=lowest direct home discharge rate, range 9.3% to 59.2%; quartile 4=highest direct home discharge rate, range 81.7% to 100.0%). There was no significant association between hospital category of direct discharge home and 30‐day readmission (P=0.14).

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  Figure 5. Risk factors for 30‐day readmission. Figure includes selected covariates (with P<0.10) for 30‐day readmission in our multivariable model. After adjustment, direct discharge home was not associated with 30‐day readmission across hospital quartiles (odds ratio quartile 4 vs quartile 1=0.89, 95%CI 0.76‐1.04). The strongest associations with 30‐day readmission were seen among patients with dialysis, in‐hospital stroke or TIA, and nonfemoral access. GFR indicates glomerular filtration rate; ICU, intensive care unit; TIA, transient ischemic attack.