Early rehospitalisation after transcatheter aortic valve implantation: incidence, predictors and impact on mortality

Background Early rehospitalisation after transcatheter aortic valve implantation (TAVI) is frequently required but data regarding its prevalence, aetiology, predictors and prognostic relevance are limited. Methods We retrospectively analysed consecutive patients undergoing TAVI between August 2012 and October 2025. Early rehospitalisation was defined as any admission within 30 days from the index hospitalisation. Data regarding rehospitalisation causes, predictors, outcomes and impact on mortality were collected. Associations were evaluated using univariable and multivariable logistic and Cox regression models and Kaplan-Meier curve analyses. Results A total of 1347 patients (43.8% women, mean age 81±6 years) were included. Early rehospitalisation was required in 131 (9.7%), most frequently due to infection (22.9%), heart failure (HF 19.8%) and bradycardia (9.9%). Independent predictors of rehospitalisation for infection were chronic HF (OR 2.60, 95% CI 1.02 to 6.59; p=0.045), chronic obstructive pulmonary disease (OR 3.18, 95% CI 1.27 to 7.96; p=0.013) and contrast dye volume (OR 1.25 per 25 mL increase, 95% CI 1.09 to 1.44; p=0.002). Rehospitalisation for decompensated HF was significantly associated with chronic HF (OR 3.82, 95% CI 1.24 to 11.81; p=0.020), paravalvular leak ≥mild (OR 5.05, 95% CI 1.50 to 16.98; p=0.009) and reduced postprocedural ejection fraction (OR 3.85, 95% CI 1.20 to 12.50; p=0.022). Conduction abnormalities at discharge predicted rehospitalisation for bradycardia requiring pacemaker implantation (OR 4.65, 95% CI 1.39 to 15.57; p=0.013). Early (≤2 days) discharge was not associated with an increased risk of rehospitalisation (27.7% vs 20.3%, p=0.073). 1-year all-cause mortality was higher for the early rehospitalisation group after multivariable adjustment (HR 3.03, 95% CI 1.90 to 4.86; p<0.001). Conclusions Nearly one-tenth of patients were readmitted after index hospitalisation. The most prevalent causes were infection, HF and bradycardia. Modifiable risk factors were contrast dye volume, ≥mild paravalvular leaks and discharge conduction abnormalities. Early discharge did not predict rehospitalisation. Mortality risk at 1 year was three times higher in patients requiring early rehospitalisation.