Incidence, Causes, and Predictors of Early (≤30 Days) and Late Unplanned Hospital Readmissions After Transcatheter Aortic Valve Replacement

Abstract

The readmission burden after TAVR in an all-comers population was high. Nearly one-fifth of the patients were readmitted early after hospital discharge, increasing the risk of mortality at follow-up. Reasons for readmission were split between noncardiac and cardiac causes, with respiratory causes and heart failure as the main diagnoses in each group, respectively. Whereas early readmissions were mainly related to periprocedural bleeding events, most late readmissions were secondary to baseline patient comorbidities. These results underscore the importance of and provide the basis for implementing specific preventive measures to reduce readmission rates after TAVR.

Impact of Frailty Markers for Unplanned Hospital Readmission Following Transcatheter Aortic Valve Implantation

“…13 Unplanned readmissions for noncardiac causes greater than for cardiac causes, which is consistent with patients who are at high surgical risk because of various extracardiac comorbidities. 2 Also, TAVI was performed in index admissions and patients were likely to be in a more stable condition from the perspective of cardiovascular disease.…”

“…13 In our sensitivity analysis, device success and early safety at 30 days did not predict unplanned readmission after TAVI, suggesting most patients in Japan with procedural compli- Advance Publication by-J-STAGE…”

“…Noncardiac causes included infection (respiratory, urinary tract, gastrointestinal, and other), trauma, anemia, ischemic stroke, bleeding, acute renal failure, and other conditions (e.g., dehydration, hyperkalemia, anaphylactic shock). 13 …”

Evaluation of current practices in transcatheter aortic valve implantation: The WRITTEN (WoRldwIde TAVI ExperieNce) survey

“…12 oral anticoagulant, typically warfarin for AF [43,44]. In this setting, the absence of consensus was even more evident and according to the results of this survey, the antithrombotic regimens were highly variable.…”

The Prognostic Impact of New‐Onset Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation: A Meta‐analysis

“…The main causes of noncardiac admission were respiratory diseases, infection, and bleeding. 32 One possible explanation for increased admission in NOP-LBBB patients is that these patients may be more vulnerable to HF exacerbation in the middle of these events (infection and bleeding). However, Urena et al and Testa et al reported no association between NOP-LBBB and HF admission.…”