Britt Borregaard1, Jordi Sanchez Dahl2, Lars Peter Schødt Riber3, Ola Ekholm4, Kirstine Lærum Sibilitz5, Marc Weiss6, Jan Sørensen7, Selina Kikkenborg Berg8, Jacob Eifer Møller9. 1. Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark; OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark. Electronic address: britt.borregaard@rsyd.dk. 2. Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Cardiology, Odense University Hospital, Odense, Denmark. 3. Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark. 4. National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. 5. Department of Cardiology, Hvidovre University Hospital, Hvidovre, Denmark. 6. Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark; Faculty of Health Sciences, University of Aarhus, Denmark. 7. Centre for Health Economics Research (COHERE), National Institute of Public Health, University of Southern Denmark, Odense, Denmark; Healthcare Outcomes Research Centre (HORC), Royal College of Surgeons in Ireland, Dublin, Ireland. 8. The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. 9. OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Cardiology, Odense University Hospital, Odense, Denmark.
Abstract
BACKGROUND: Unplanned readmissions after heart valve surgery are common, and constitute a significant burden for the patient and the health care system. The objective was to investigate the effect of individualised follow-up after open heart valve surgery on a composite endpoint of first unplanned cardiac hospital readmission or all-cause mortality within 180 days of discharge. METHODS: The study is a prospective cohort study comparing the composite endpoint in patients undergoing early, individualised and intensified follow-up after heart valve surgery with a propensity matched historical control group. A total of 308 consecutive patients were enrolled in the prospective cohort study, 980 consecutive patients comprised the control group. The propensity matched group consisted of n = 300 (intervention) and n = 580 (controls). Time to first event was analysed using uni- and multivariable Cox proportional hazard analysis. Kaplan-Meier survival curves were constructed to assess the probability of survival without readmission. RESULTS: After 180 days, the proportion of patients experiencing the composite endpoint was significantly lower in the intervention group compared with the controls for the overall, unmatched population (23% vs. 38%; HR 0.55; 95% CI, 0.42 to 0.73; P < 0.001). The effect did not change in the propensity matched population (HR 0.57; 95% CI 0.43;0.75, P < 0.001). The difference was related to reduction in readmission rates, whereas death rates were similar in intervention and control group (1.6% vs. 1.8%). CONCLUSION: An intervention consisting of early, individualised and intensified follow-up after open heart valve surgery reduced the risk of a composite endpoint of first, unplanned cardiac hospital readmission or all-cause mortality within 180 days.
BACKGROUND: Unplanned readmissions after heart valve surgery are common, and constitute a significant burden for the patient and the health care system. The objective was to investigate the effect of individualised follow-up after open heart valve surgery on a composite endpoint of first unplanned cardiac hospital readmission or all-cause mortality within 180 days of discharge. METHODS: The study is a prospective cohort study comparing the composite endpoint in patients undergoing early, individualised and intensified follow-up after heart valve surgery with a propensity matched historical control group. A total of 308 consecutive patients were enrolled in the prospective cohort study, 980 consecutive patients comprised the control group. The propensity matched group consisted of n = 300 (intervention) and n = 580 (controls). Time to first event was analysed using uni- and multivariable Cox proportional hazard analysis. Kaplan-Meier survival curves were constructed to assess the probability of survival without readmission. RESULTS: After 180 days, the proportion of patients experiencing the composite endpoint was significantly lower in the intervention group compared with the controls for the overall, unmatched population (23% vs. 38%; HR 0.55; 95% CI, 0.42 to 0.73; P < 0.001). The effect did not change in the propensity matched population (HR 0.57; 95% CI 0.43;0.75, P < 0.001). The difference was related to reduction in readmission rates, whereas death rates were similar in intervention and control group (1.6% vs. 1.8%). CONCLUSION: An intervention consisting of early, individualised and intensified follow-up after open heart valve surgery reduced the risk of a composite endpoint of first, unplanned cardiac hospital readmission or all-cause mortality within 180 days.
Authors: Lizette N Abraham; Kirstine L Sibilitz; Selina K Berg; Lars H Tang; Signe S Risom; Jane Lindschou; Rod S Taylor; Britt Borregaard; Ann-Dorthe Zwisler Journal: Cochrane Database Syst Rev Date: 2021-05-07
Authors: Britt Borregaard; Jordi Sanchez Dahl; Lars Peter Schødt Riber; Ola Ekholm; Kirstine Lærum Sibilitz; Marc Weiss; Jan Sørensen; Selina Kikkenborg Berg; Jacob Eifer Møller Journal: Data Brief Date: 2019-04-23
Authors: Britt Borregaard; Jordi S Dahl; Sandra B Lauck; Jesper Ryg; Selina K Berg; Ola Ekholm; Jeroen M Hendriks; Lars P S Riber; Tone M Norekvål; Jacob E Møller Journal: Int J Cardiol Heart Vasc Date: 2020-11-13
Authors: Marta Sitges; Britt Borregaard; Ruggero De Paulis; Paul Nolan; Wil Woan; Keith Pearce; Jens Näumann; Neil Johnson; Suzanne Wait Journal: Eur Heart J Open Date: 2021-11-09
Authors: Britt Borregaard; Jacob Eifer Møller; Jordi Sanchez Dahl; Lars Peter Schødt Riber; Selina Kikkenborg Berg; Ola Ekholm; Marc Gjern Weiss; Emilie Karense Lykking; Kirstine Lærum Sibilitz; Jan Sørensen Journal: Open Heart Date: 2019-11-11
Authors: Britt Borregaard; Jordi S Dahl; Ola Ekholm; Emil Fosbøl; Lars P S Riber; Kirstine L Sibilitz; Sasja M Pedersen; Thomas P H Rothberg; Maiken H Nielsen; Selina K Berg; Jacob E Møller Journal: PLoS One Date: 2020-10-07 Impact factor: 3.240
Authors: Sandra B Lauck; Suzanne J Baron; William Irish; Britt Borregaard; Kimberly A Moore; Candace L Gunnarsson; Seth Clancy; David A Wood; Vinod H Thourani; John G Webb; Harindra C Wijeysundera Journal: J Am Heart Assoc Date: 2021-09-28 Impact factor: 5.501