Multidisciplinary Approach for Patients Hospitalized With Heart Failure

Frankenstein, Lutz; Fröhlich, Hanna; Cleland, John G.F.

doi:10.1016/j.rec.2015.05.008

Cited by 12 publications

(11 citation statements)

References 80 publications

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“…1 Lastly, the high observed 30-day (13.5%) and 1-year (44.0%) readmission rates noted in elective cases highlights the need to develop strategies aimed at reducing readmission risk such as postdischarge transitional care and early physician follow-up. 25,30 Our study should be interpreted in the context of several limitations that merit discussion. Since 2014, advances in technology, including reductions in catheter size, improvement in delivery systems, and increasing use of conscious sedation rather than general anesthesia, may limit the generalizability of our findings.…”

Section: Discussionmentioning

confidence: 96%

“…Alternatively, given the extensive and often prolonged preprocedural work‐up period, it maybe that there is greater attention to planning and establishing appropriate transitional care, such as homecare or rehabilitation in anticipation of the TAVR procedure. Indeed, such transition of care measures have been found to be effective methods of mitigating readmission risk . Further study of the impact of transitional care on readmission risk is warranted.…”

Section: Discussionmentioning

confidence: 99%

“…Given that a substantial portion of the costs associated with TAVR are incurred during the time spent in‐hospital after the index procedure, shortening post‐TAVR length of stay holds promise in reducing costs and improving the efficiency of care without compromising quality of care, namely early readmission . Lastly, the high observed 30‐day (13.5%) and 1‐year (44.0%) readmission rates noted in elective cases highlights the need to develop strategies aimed at reducing readmission risk such as postdischarge transitional care and early physician follow‐up …”

Section: Discussionmentioning

confidence: 99%

“…Indeed, such transition of care measures have been found to be effective methods of mitigating readmission risk. [24][25][26] Further study of the impact of transitional care on readmission risk is warranted. In contrast, the association with increasing length of stay and heightened readmission risk at 1 year may have been a marker of the underlying complex cardiac disease and comorbidities common to highrisk and inoperable patients with severe aortic stenosis, rather than a proxy for the index procedure and care delivered during the index hospitalization.…”

Section: Discussionmentioning

confidence: 99%

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Short Length of Stay After Elective Transfemoral Transcatheter Aortic Valve Replacement is Not Associated With Increased Early or Late Readmission Risk

Sud

Qui

Austin

et al. 2017

JAHA

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BackgroundElderly patients undergoing transcatheter aortic valve replacement (TAVR) are at risk of hospital readmission postprocedure. It is not known whether the index hospital length of stay and, specifically, early discharge post‐TAVR is associated with an increased risk of readmission. We hypothesized a nonlinear relationship whereby both short and long lengths of stay were associated with increased readmission risk.Methods and ResultsWe performed a retrospective multicenter cohort analysis of patients undergoing elective transfemoral TAVR and surviving to discharge between January 2007 and March 2014. The exposure variable was hospital length of stay measured from the procedure date to the date of discharge and modeled as a continuous variable in a multivariable cause‐specific Cox regression. Main outcome measures were 30‐day and 1‐year all‐cause readmissions. The study population consisted of 709 patients with a median length of stay of 6 days (interquartile range, 4–8). At 30‐days and 1‐year, 13.5% and 44.0% of patients were readmitted, respectively. Although post‐TAVR length of stay was not associated with 30‐day all‐cause readmissions (P=0.925), there existed a significant association with 1‐year readmission (P=0.010) after adjustment for baseline clinical variables. The association between post‐TAVR length of stay and 1‐year readmission was linear (P=0.549 for nonlinearity) with no evidence supporting an increased readmission risk for shorter length of stays.ConclusionsAmong elderly survivors of elective transfemoral TAVR, a short postprocedural length of stay was not associated with an increased risk readmission within 30 days or 1 year. However, the risk of 1‐year readmission increased with longer post‐TAVR lengths of stay.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Short Length of Stay After Elective Transfemoral Transcatheter Aortic Valve Replacement is Not Associated With Increased Early or Late Readmission Risk

Sud

Qui

Austin

et al. 2017

JAHA

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“…These interventions reduce the risk of HF-related hospitalisations and allcause death in most patients, but the same result has not been found for patients with depressive symptoms, which is common in the HF patient population [15,16].…”

Section: Introductionmentioning

confidence: 90%

Caring needs in patient-partner dyads affected by heart failure: An evaluation of the long-term effects of a dyadic psycho-educational intervention

Liljeroos¹

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Saudi Heart Association (SHA) guidelines for the management of heart failure

AlHabeeb

AlAyoubi

Alghalayini

et al. 2019

Journal of the Saudi Heart Association

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Heart failure (HF) is the leading cause of morbidity and mortality worldwide and negatively impacts quality of life, healthcare costs, and longevity. Although data on HF in the Arab population are scarce, recently developed regional registries are a step forward to evaluating the quality of current patient care and providing an overview of the clinical picture. Despite the burden of HF in Saudi Arabia, there are currently no standardized protocols or guidelines for the management of patients with acute or chronic heart failure. Therefore, the Heart Failure Expert Committee, comprising 13 local specialists representing both public and private sectors, has developed guidelines to address the needs and challenges for the diagnosis and treatment of HF in Saudi Arabia. The ultimate aim of these guidelines is to assist healthcare professionals in delivering optimal care and standardized clinical practice across Saudi Arabia.

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Multidisciplinary Approach for Patients Hospitalized With Heart Failure

Cited by 12 publications

References 80 publications

Short Length of Stay After Elective Transfemoral Transcatheter Aortic Valve Replacement is Not Associated With Increased Early or Late Readmission Risk

Short Length of Stay After Elective Transfemoral Transcatheter Aortic Valve Replacement is Not Associated With Increased Early or Late Readmission Risk

Caring needs in patient-partner dyads affected by heart failure: An evaluation of the long-term effects of a dyadic psycho-educational intervention

Saudi Heart Association (SHA) guidelines for the management of heart failure

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