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September 10, 2026European Heart Journal - Valvular and Structural Heart DiseaseOpen Access

Prognostic Impact of Domiciliary Care Prior to Transcatheter Aortic Valve Implantation: A Nationwide Study

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Why the study?

The relationship between receiving domiciliary care prior to TAVI and clinical outcomes had not been systematically evaluated.

Does receipt of domiciliary care prior to TAVI predict increased mortality and hospitalization in adult patients with aortic stenosis?

Population

7,607 adult patients undergoing first-time TAVI for aortic stenosis

Comparison

Domiciliary care vs no domiciliary care within 1 year prior to TAVI

Design

Nationwide cohort study

Follow-up

1 year

Key result

Receipt of domiciliary care prior to TAVI was associated with increased 1-year mortality compared to no domiciliary care (21.5% vs 6.4%; HR 3.30; 95% CI 2.65-4.10; p<0.0001).

Authors

VMVictoria MikkelsenJPJeppe Kofoed PetersenMMMartha Meibom

Discussion

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Overview

Prior domiciliary care flags high-mortality TAVI patients; leaves open whether frailty markers should refine selection or post-procedure support.

Key Points

  • To evaluate the association between receipt of domiciliary care prior to first-time transcatheter aortic valve implantation (TAVI) and 1-year clinical outcomes.
  • Nationwide cohort study of adult patients undergoing first-time TAVI for aortic stenosis between January 1, 2015, and December 31, 2023 (N=7,607).
  • Patients were categorized by whether they received domiciliary care within 1 year before TAVI and followed for 1 year post-procedure.
  • Primary outcomes included all-cause mortality assessed via multivariable Cox proportional hazards models and >14 cumulative days of hospitalization assessed via multivariable logistic regression.
  • The absolute 1-year risk of death from discharge was 21.5% in patients with prior domiciliary care versus 6.4% in those without.
  • In adjusted analyses, prior domiciliary care was significantly associated with higher 1-year all-cause mortality (HR 3.30; 95% CI 2.65–4.10, p < 0.0001).
  • Prior domiciliary care was also associated with increased odds of >14 cumulative days of hospitalization within 1 year post-TAVI (OR 2.94; 95% CI 2.41–3.59, p < 0.0001).

Study Design

Type

Cohort (n=7,607)

Multicenter

Yes

Structured PICO

Does receipt of domiciliary care prior to TAVI predict increased mortality and hospitalization in adult patients with aortic stenosis?

P
Population
7,607 adult patients with aortic stenosis undergoing first-time TAVI, categorized by receipt of pre-procedural domiciliary care and followed for 1 year.
E
Exposure
Receipt of domiciliary care within 1 year prior to TAVI (n=541)
C
Comparator
No domiciliary care within 1 year prior to TAVI (n=7,066)
O
Outcome
All-cause mortality at 1 year after TAVIhard clinical

Main Result

Hazard Ratio: 3.3 (95% CI 2.65–4.1)

Absolute Event Rate: 21.5% vs 6.4%

p-value: p=< 0.0001

Receipt of domiciliary care prior to TAVI is a strong marker of frailty associated with a more than three-fold increased risk of 1-year mortality and higher cumulative hospitalization days.

Cite This Study

Mikkelsen et al. (2026) conducted a cohort in Aortic stenosis (n=7,607). Domiciliary care vs. No domiciliary care was evaluated on All-cause mortality (HR 3.30, 95% CI 2.65-4.10, p=< 0.0001). Receipt of domiciliary care prior to TAVI was associated with increased 1-year mortality compared to no domiciliary care (21.5% vs 6.4%; HR 3.30; 95% CI 2.65-4.10; p<0.0001).

synapsesocial.com/papers/6aa27c2058559d80afc75ba8https://doi.org/10.1093/ehjvshd/xwag079
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