Rates and predictors of hospital readmission after transcatheter aortic valve implantation.

Franzone, Anna; Pilgrim, Thomas; Arnold, Nicolas; Heg, Dik; Langhammer, Bettina; Piccolo, Raffaele; Roost, Eva; Praz, Fabien; Räber, Lorenz; Valgimigli, Marco; Wenaweser, Peter; Jüni, Peter; Carrel, Thierry; Windecker, Stephan; Stortecky, Stefan (2017). Rates and predictors of hospital readmission after transcatheter aortic valve implantation. European Heart Journal, 38(28), pp. 2211-2217. Oxford University Press 10.1093/eurheartj/ehx182

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Aims To analyse reasons, timing and predictors of hospital readmissions after transcatheter aortic valve implantation (TAVI). Methods and Results Patients included in the Bern TAVI Registry between August 2007 and June 2014 were analysed. Fine and Gray competing risk regression was used to identify factors predictive of hospital readmission within 1 year after TAVI with bootstrap analysis for internal validation. Of 868 patients alive at discharge, 221 (25.4%) were readmitted within 1 year. Compared with patients not requiring readmission, those with at least one readmission more frequently were male and more often had atrial fibrillation and higher creatinine values (P < 0.05 for all cases). For overall 308 readmissions, cardiovascular causes accounted for 46.1% with heart failure as the most frequent indication; non-cardiovascular readmissions occurred for surgery (11.7%), gastrointestinal disorders (9.7%), malignancy (4.9%), respiratory diseases (4.6%) and chronic kidney failure (2.6%). Male gender (subhazard ratio, SHR, 1.33, 95% confidence intervals, CI, 1.02-1.73, P = 0.035) and stage 3 kidney injury (SHR 2.04, 95% CI 1.12-3.71, P = 0.021) were found independent risk factors for any hospital readmission, whereas previous myocardial infarction (SHR 1.88, 95% CI 1.22-2.90, P = 0.004) and in-hospital life-threatening bleeding (SHR 2.18, 95%CI 1.24-3.85, P = 0.007) were associated with cardiovascular readmissions. The event rate for mortality was significantly increased after readmissions for any cause (RR 4.29, 95% CI 2.86-6.42, P < 0.001). Conclusion Hospital readmission was observed in one out of four patients during the first year after TAVI and was associated with a significant increase in mortality.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Franzone, Anna; Pilgrim, Thomas; Heg, Dierik Hans; Langhammer, Bettina; Piccolo, Raffaele; Roost, Eva; Praz, Fabien; Räber, Lorenz; Valgimigli, Marco; Carrel, Thierry; Windecker, Stephan and Stortecky, Stefan

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0195-668X

Publisher:

Oxford University Press

Language:

English

Submitter:

Daniela Huber

Date Deposited:

20 Sep 2017 09:38

Last Modified:

07 Jun 2018 09:03

Publisher DOI:

10.1093/eurheartj/ehx182

PubMed ID:

28430920

Uncontrolled Keywords:

Hospital readmission Predictors Transcatheter aortic valve implantation

BORIS DOI:

10.7892/boris.101640

URI:

https://boris.unibe.ch/id/eprint/101640

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