Thirty-day readmission after TAVR occurred in 17.9% of patients, with noncardiac causes accounting for 61.8% of cases and cardiac causes for 38.2%.
Observational (n=12,221)
Yes
What are the incidence, predictors, causes, and costs of 30-day readmissions after TAVR?
Thirty-day readmissions after TAVR are frequent (17.9%), predominantly due to noncardiac causes, and are associated with baseline comorbidities and post-procedure complications.
BACKGROUND: Readmissions after cardiac procedures are common and contribute to increased healthcare utilization and costs. Data on 30-day readmissions after transcatheter aortic valve replacement (TAVR) are limited. METHODS AND RESULTS: Patients undergoing TAVR (International Classification of Diseases-Ninth Revision-CM codes 35. 05 and 35. 06) between January and November 2013 who survived the index hospitalization were identified in the Nationwide Readmissions Database. Incidence, predictors, causes, and costs of 30-day readmissions were analyzed. Of 12 221 TAVR patients, 2188 (17. 9%) were readmitted within 30 days. Length of stay >5 days during index hospitalization (hazard ratio HR, 1. 47; 95% confidence interval CI, 1. 24-1. 73), acute kidney injury (HR, 1. 23; 95% CI, 1. 05-1. 44), >4 Elixhauser comorbidities (HR, 1. 22; 95% CI, 1. 03-1. 46), transapical TAVR (HR, 1. 21; 95% CI, 1. 05-1. 39), chronic kidney disease (HR, 1. 20; 95% CI, 1. 04-1. 39), chronic lung disease (HR, 1. 16; 95% CI, 1. 01-1. 34), and discharge to skilled nursing facility (HR, 1. 16; 95% CI, 1. 01-1. 34) were independent predictors of 30-day readmission. Readmissions were because of noncardiac causes in 61. 8% of cases and because of cardiac causes in 38. 2% of cases. Respiratory (14. 7%), infections (12. 8%), bleeding (7. 6%), and peripheral vascular disease (4. 3%) were the most common noncardiac causes, whereas heart failure (22. 5%) and arrhythmias (6. 6%) were the most common cardiac causes of readmission. Median length of stay and cost of readmissions were 4 days (interquartile range, 2-7 days) and 8302 (interquartile range, 5229-16 021), respectively. CONCLUSIONS: Thirty-day readmissions after TAVR are frequent and are related to baseline comorbidities, TAVR access site, and post-procedure complications. Awareness of these predictors can help identify and target high-risk patients for interventions to reduce readmissions and costs.
Kolte et al. (Fri,) conducted a observational in Transcatheter aortic valve replacement (n=12,221). Transcatheter aortic valve replacement was evaluated on 30-day readmission. Thirty-day readmission after TAVR occurred in 17.9% of patients, with noncardiac causes accounting for 61.8% of cases and cardiac causes for 38.2%.