Author + information
- John A. Dodson,
- Mathew Williams,
- Sreekanth Vemulapalli,
- Pratik Manandhar,
- David Cohen,
- Caroline Blaum,
- Hua Zhong,
- John Rumsfeld and
- Judith Hochman
Background: Nearly 1 in 6 patients experience readmission within 30 days of discharge after TAVR. The association between discharge disposition (direct-home vs. skilled nursing facility) and readmission has not been explored in U.S. hospitals.
Methods: We used the STS/ACC TVT Registry to evaluate readmissions among patients undergoing TAVR (2011-2014) discharged alive with 30-day follow-up data. Hospitals were divided into quartiles (Q1-Q4) based on % of patients discharged directly home (Q4 = highest % direct-home discharge). Characteristics within quartiles were assessed. Hierarchical logistic regression was used to analyze association of discharge disposition with 30-day readmission.
Results: We identified 18,956 patients from 329 U.S. hospitals (median age 84 years). Overall, 69% of patients were discharged directly home. Characteristics within quartiles are shown in the Table. The median 30-day readmission rate was 18% (IQR 13%-22%). There was no significant association between direct-home discharge and 30-day readmission (Q4: 16%; Q1: 19%, P=0.15). This finding did not change with risk adjustment (OR Q4 vs. Q1 = 0.89, 95% CI 0.76-1.04). Direct home discharge was most strongly associated with procedural details and region of U.S. (Table).
Conclusions: Our findings suggest that the hospital practice of direct home discharge post-TAVR does not confer excessive readmission risk. Further research is needed to understand regional variation in this practice and strategies to optimize care.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 2
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1195-195
- 2017 American College of Cardiology Foundation