National trends in readmission rates after transcatheter aortic valve replacement versus surgical aortic valve replacement with severe aortic stenosis
Journal of the American College of Cardiology, 2020•jacc.org
Background Transcatheter aortic valve replacement (TAVR) has emerged for the treatment
of severe aortic stenosis (AS) in high and intermediate risk patients. We intended to study
the national trends in readmission rates, in patients underwent TAVR versus surgical aortic
valve replacement (SAVR). Methods Using the National Readmission Database, we
identified all hospitalizations from 2012 to 2016 with the primary diagnosis of severe AS
underwent either TAVR or SAVR. We identified trends in 90-day all-cause and disease …
of severe aortic stenosis (AS) in high and intermediate risk patients. We intended to study
the national trends in readmission rates, in patients underwent TAVR versus surgical aortic
valve replacement (SAVR). Methods Using the National Readmission Database, we
identified all hospitalizations from 2012 to 2016 with the primary diagnosis of severe AS
underwent either TAVR or SAVR. We identified trends in 90-day all-cause and disease …
Background
Transcatheter aortic valve replacement (TAVR) has emerged for the treatment of severe aortic stenosis (AS) in high and intermediate risk patients. We intended to study the national trends in readmission rates, in patients underwent TAVR versus surgical aortic valve replacement (SAVR).
Methods
Using the National Readmission Database, we identified all hospitalizations from 2012 to 2016 with the primary diagnosis of severe AS underwent either TAVR or SAVR. We identified trends in 90-day all-cause and disease-specific readmission rates, in-hospital complications using multivariable logistic regression.
Results
An estimated 221,371 hospitalizations were identified, of which TAVR were 62,484 (28.2%) and SAVR were158, 887 (71.7%). Baseline characteristics were significantly different between the two groups with higher prevalence of comorbidities in the TAVR group. From 2012 to 2016, the 90-day all-cause readmission rate decreased for TAVR from 26.2% to 21.4%(p trend= 0.002) and SAVR from 20.7% to 16.4%(p trend= 0.033). 90-day disease-specific readmission rate in TAVR group was 23.6% compared to 18.9% in SAVR group (p< 0.001).
Conclusion
Our findings suggest that both readmissions related to TAVR and SAVR are decreasing, although TAVR related readmissions were higher. The improvement in TAVR related readmissions is likely related to the improving safety of the procedure while the decrease in SAVR readmissions is likely related to the high-risk patients undergoing TAVR.
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