Journal article
Impact of post-procedural length of stay on short-term outcomes and readmissions after TAVR and MitraClip
American heart journal plus, Vol.13, pp.100130-100130
01/2022
DOI: 10.1016/j.ahjo.2022.100130
PMCID: PMC10978317
PMID: 38560061
Abstract
Post-procedural hospital length of stay (P-LOS) is an important determinant of cost-related outcomes. In the present study, we aimed to assess the impact of P-LOS on short-term outcomes after transcatheter aortic valve replacement (TAVR) and MitraClip.
We performed a retrospective cohort study, retrieving data from the National Readmissions Database (NRD) for patients who underwent transfemoral TAVR and MitraClip between January 2014 and December 2017. We employed multivariable logistic regression to evaluate the association between P-LOS and 30-day all-cause mortality and readmissions.
A total of 65,726 and 7347 patients underwent TAVR and MitraClip, respectively within the study period. After 30 days of discharge, 13.7% and 15.1% of TAVR and MitraClip patients were readmitted for any reason, while 0.5% and 0.9% died within the readmission hospitalization. A longer P-LOS was associated with an increased risk of 30-day all-cause readmission in both TAVR (OR = 1.027, 95% CI [1.023–1.032]) and MitraClip (OR = 1.025, 95%CI [1.012–1.038]) patients. This finding remained true for patients who developed or did not develop complications after both procedures. In terms of 30-day inhospital mortality, a longer P-LOS was associated with a higher risk in TAVR patients (OR = 1.039, 95%CI [1.028–1.049]), but no increased risk in MitraClip patients (OR = 1.014, 95%CI [0.985–1.044]). Other predictors of 30-day readmission after both procedures included heart failure, post-procedural acute kidney injury, and discharge with disability.
The current study shows that shorter P-LOS was associated with reduced risk of short-term readmission after both TAVR and MitraClip and reduced short-term mortality after TAVR (mainly in patients who developed post-procedural complications). Shorter P-LOS is a predictor of readmission and sicker patient group. Patients requiring longer LOS should be followed closely to prevent readmission and enhance better outcomes. Future studies evaluating P-LOS impact on long-term and patient-oriented outcomes are needed.
Details
- Title: Subtitle
- Impact of post-procedural length of stay on short-term outcomes and readmissions after TAVR and MitraClip
- Creators
- Omar M. Abdelfattah - Morristown Medical CenterAbdelrahman I. Abushouk - Cleveland ClinicAnas M. Saad - Cleveland ClinicMohamed M. Gad - Cleveland ClinicToshiaki Isogai - Cleveland ClinicYehia Saleh - Houston MethodistShashank Shekhar - Cleveland ClinicMina Iskander - Yale New Haven HospitalMohamed Omer - Mayo Clinic in ArizonaRyan Kaple - Yale New Haven HospitalAmar Krishnaswamy - Cleveland ClinicSamir R. Kapadia - Cleveland Clinic
- Resource Type
- Journal article
- Publication Details
- American heart journal plus, Vol.13, pp.100130-100130
- DOI
- 10.1016/j.ahjo.2022.100130
- PMID
- 38560061
- PMCID
- PMC10978317
- NLM abbreviation
- Am Heart J Plus
- ISSN
- 2666-6022
- eISSN
- 2666-6022
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 01/2022
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984755385202771
Metrics
4 Record Views