Same-Day Discharge After Transcatheter Aortic Valve Implantation: Insights from the Nationwide Readmission Database 2015 to 2019.
Department
Cardiology
Document Type
Article
Publication Title
Journal of the American Heart Association
Abstract
Background: There is a paucity of data on the feasibility of same-day discharge (SDD) following transcatheter aortic valve implantation (TAVI) at a national level.
Methods and Results: This study used data from the Nationwide Readmission Database from the fourth quarter of 2015 through 2019 and identified patients undergoing TAVI using the claim code 02RF3. A total of 158 591 weighted hospitalizations for TAVI were included in the analysis. Of the patients undergoing TAVI, 961 (0.6%) experienced SDD. Non-SDDs included 65 814 (41.5%) patients who underwent TAVI who were discharged the next day, and 91 816 (57.9%) discharged on the second or third day. The 30-day readmission rate for SDD after TAVI was similar to non-SDD TAVI (9.8% versus 8.9%, P=0.31). The cumulative incidence of 30-day readmissions for SDD was higher compared with next-day discharge (log-rank P=0.01) but comparable to second- or third-day discharge (log-rank P=0.66). At 30 days, no differences were observed in major or minor vascular complications, heart failure, or ischemic stroke for SDD compared with non-SDD. Acute kidney injury, pacemaker implantation, and bleeding complications were lower with SDD. Predictors associated with SDD included age < 85 years, male sex, and prior pacemaker placement, whereas left bundle-branch block, right bundle-branch block, second-degree heart block, heart failure, prior percutaneous coronary intervention, and atrial fibrillation were negatively associated with SDD.
Conclusions: SDD following TAVI is associated with similar 30-day readmission and complication rates compared with non-SDD. Further prospective studies are needed to assess the safety and feasibility of SDD after TAVI.
First Page
e024746
DOI
10.1161/JAHA.121.024746
Volume
11
Issue
11
Publication Date
6-7-2022
Medical Subject Headings
Aged, 80 and over; Aortic Valve; Aortic Valve Stenosis; Bundle-Branch Block; Heart Failure; Humans; Male; Patient Discharge; Patient Readmission; Retrospective Studies; Risk Factors; Transcatheter Aortic Valve Replacement; Treatment Outcome
PubMed ID
35621233
Recommended Citation
Zahid, S., Rai, D., Tanveer Ud Din, M., Khan, M., Ullah, W., Usman Khan, M., Thakkar, S., Hussein, A., Baibhav, B., Rao, M., Abtahian, F., Bhatt, D., & Depta, J. P. (2022). Same-Day Discharge After Transcatheter Aortic Valve Implantation: Insights from the Nationwide Readmission Database 2015 to 2019.. Journal of the American Heart Association, 11 (11), e024746. https://doi.org/10.1161/JAHA.121.024746