• European heart journal · Jul 2017

    Observational Study

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

    • Anna Franzone, Thomas Pilgrim, Nicolas Arnold, Dik Heg, Bettina Langhammer, Raffaele Piccolo, Eva Roost, Fabien Praz, Lorenz Räber, Marco Valgimigli, Peter Wenaweser, Peter Jüni, Thierry Carrel, Stephan Windecker, and Stefan Stortecky.
    • Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, Freiburgstrasse 8, 3010 Bern, Switzerland.
    • Eur. Heart J. 2017 Jul 21; 38 (28): 2211-2217.

    AimsTo analyse reasons, timing and predictors of hospital readmissions after transcatheter aortic valve implantation (TAVI).Methods And ResultsPatients 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).ConclusionHospital readmission was observed in one out of four patients during the first year after TAVI and was associated with a significant increase in mortality.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

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