Edward L Hannan1, Zaza Samadashvili2, Desmond Jordan2, Thoralf M Sundt2, Nicholas J Stamato2, Stephen J Lahey2, Jeffrey P Gold2, Andrew Wechsler2, Mohammed H Ashraf2, Carlos Ruiz2, Sean Wilson2, Craig R Smith2. 1. From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.). elh03@health.state.ny.us. 2. From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.).
Abstract
BACKGROUND: Several studies have compared short-term and medium-term mortality rates for patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR), but no studies have compared short-term readmission rates for the 2 procedures. METHODS AND RESULTS: New York's Cardiac Surgery Reporting System was used to propensity match 617 TAVI and 1981 SAVR patients using numerous patient risk factors contained in the registry. The 389 propensity-matched pairs were then used to analyze differences in readmission rates between the 2 groups. TAVI and SAVR readmission rates were also compared for patients with a history of congestive heart failure and for patients aged ≥80. Also, reasons for readmission for TAVI and SAVR patients were examined and compared. Readmission rates were not statistically different for all propensity-matched TAVI and SAVR patients (respective rates, 18.8% and 19.3%; P=0.86). After further adjustment using a logistic regression model, there was still no significant difference (adjusted odds ratio, 0.97; 95% confidence interval [0.68-1.39]). For patients aged ≥80, the 30-day readmission rates were 19.9% and 22.0% (P=0.59), and when further adjusted using the logistic regression model, adjusted odds ratio=0.89 (0.55-1.45). For patients with a history of congestive heart failure, the respective rates were 22.8% and 20.4% (P=0.56), and with further adjustment, adjusted odds ratio became 1.15 (0.72-1.82). CONCLUSIONS: There are no statistically significant differences between TAVI and SAVR patients in short-term readmission rates.
BACKGROUND: Several studies have compared short-term and medium-term mortality rates for patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR), but no studies have compared short-term readmission rates for the 2 procedures. METHODS AND RESULTS: New York's Cardiac Surgery Reporting System was used to propensity match 617 TAVI and 1981 SAVR patients using numerous patient risk factors contained in the registry. The 389 propensity-matched pairs were then used to analyze differences in readmission rates between the 2 groups. TAVI and SAVR readmission rates were also compared for patients with a history of congestive heart failure and for patients aged ≥80. Also, reasons for readmission for TAVI and SAVR patients were examined and compared. Readmission rates were not statistically different for all propensity-matched TAVI and SAVR patients (respective rates, 18.8% and 19.3%; P=0.86). After further adjustment using a logistic regression model, there was still no significant difference (adjusted odds ratio, 0.97; 95% confidence interval [0.68-1.39]). For patients aged ≥80, the 30-day readmission rates were 19.9% and 22.0% (P=0.59), and when further adjusted using the logistic regression model, adjusted odds ratio=0.89 (0.55-1.45). For patients with a history of congestive heart failure, the respective rates were 22.8% and 20.4% (P=0.56), and with further adjustment, adjusted odds ratio became 1.15 (0.72-1.82). CONCLUSIONS: There are no statistically significant differences between TAVI and SAVR patients in short-term readmission rates.
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