Impact of Transcatheter Aortic Valve Replacement on Hospitalization Rates: Insights From Nationwide Readmission Database

Background Hospitalization rates after transcatheter aortic valve replacement (TAVR) remain high, given the age and comorbidities of patients undergoing TAVR. To better understand the impact of TAVR on hospitalization, we sought to compare hospitalization rates before and after TAVR and to examine i...

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Bibliographic Details
Published in:Journal of the American Heart Association 2021-11, Vol.10 (21), p.e022910-e022910
Main Authors: Elkaryoni, Ahmed, Chhatriwalla, Adnan K, Kennedy, Kevin F, Saxon, John T, Lopez, John J, Cohen, David J, Arnold, Suzanne V
Format: Article
Language:English
Subjects:
Aged, 80 and over
Aortic Valve - surgery
Aortic Valve Stenosis - epidemiology
Aortic Valve Stenosis - surgery
comorbidities
Female
Hospitalization
hospitalizations
Humans
Male
Original Research
Patient Readmission
Risk Factors
Time Factors
transcatheter aortic valve replacement
Transcatheter Aortic Valve Replacement - adverse effects
Treatment Outcome
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Summary:Background Hospitalization rates after transcatheter aortic valve replacement (TAVR) remain high, given the age and comorbidities of patients undergoing TAVR. To better understand the impact of TAVR on hospitalization, we sought to compare hospitalization rates before and after TAVR and to examine if underlying patient comorbidities are associated with a differential effect of TAVR on hospitalizations. Methods and Results We used the Nationwide Readmissions Database to identify patients who underwent TAVR. As Nationwide Readmissions Database data do not cross over calendar years, we limited our index admission to hospitalizations during April to September of each calendar year to allow 90 days of observation before and after TAVRs. We calculated the daily risk of all-cause hospitalization and used a mixed-effects logistic regression model to explore interactions between patient characteristics, TAVR, and hospitalization risk. Among 39 249 patients who underwent TAVR in 2014 to 2017 (median age, 82 years [interquartile range, 76-87 years]; 45.7% women), 32.0% had at least one hospitalization in the 90 days before TAVR compared with 23.2% in the 90 days post-TAVR (relative reduction, 27.5%;
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.121.022910