Thirty-day readmissions after transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis in New York State

Edward L. Hannan, Zaza Samadashvili, Desmond Jordan, Thoralf M. Sundt, Nicholas J. Stamato, Stephen J. Lahey, Jeffrey P Gold, Andrew Wechsler, Mohammed H. Ashraf, Carlos Ruiz, Sean Wilson, Craig R. Smith

Research output: Contribution to journalArticle

30 Citations (Scopus)

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.

Original languageEnglish (US)
Article numbere002744
JournalCirculation: Cardiovascular Interventions
Volume8
Issue number8
DOIs
StatePublished - Aug 1 2015

Fingerprint

Aortic Valve Stenosis
Aortic Valve
Surgical Instruments
Logistic Models
Odds Ratio
Heart Failure
Transcatheter Aortic Valve Replacement
Thoracic Surgery
Registries
Confidence Intervals
Mortality

Keywords

  • aortic valve stenosis
  • heart failure
  • patient readmission
  • risk factors
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Thirty-day readmissions after transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis in New York State. / Hannan, Edward L.; Samadashvili, Zaza; Jordan, Desmond; Sundt, Thoralf M.; Stamato, Nicholas J.; Lahey, Stephen J.; Gold, Jeffrey P; Wechsler, Andrew; Ashraf, Mohammed H.; Ruiz, Carlos; Wilson, Sean; Smith, Craig R.

In: Circulation: Cardiovascular Interventions, Vol. 8, No. 8, e002744, 01.08.2015.

Research output: Contribution to journalArticle

Hannan, Edward L. ; Samadashvili, Zaza ; Jordan, Desmond ; Sundt, Thoralf M. ; Stamato, Nicholas J. ; Lahey, Stephen J. ; Gold, Jeffrey P ; Wechsler, Andrew ; Ashraf, Mohammed H. ; Ruiz, Carlos ; Wilson, Sean ; Smith, Craig R. / Thirty-day readmissions after transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis in New York State. In: Circulation: Cardiovascular Interventions. 2015 ; Vol. 8, No. 8.
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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.",
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T1 - Thirty-day readmissions after transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis in New York State

AU - Hannan, Edward L.

AU - Samadashvili, Zaza

AU - Jordan, Desmond

AU - Sundt, Thoralf M.

AU - Stamato, Nicholas J.

AU - Lahey, Stephen J.

AU - Gold, Jeffrey P

AU - Wechsler, Andrew

AU - Ashraf, Mohammed H.

AU - Ruiz, Carlos

AU - Wilson, Sean

AU - Smith, Craig R.

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N2 - 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.

AB - 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.

KW - aortic valve stenosis

KW - heart failure

KW - patient readmission

KW - risk factors

KW - transcatheter aortic valve replacement

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