Trends in Outcomes, Complications and Readmission Rates of Transcatheter Aortic Valve Replacement: A Nationwide Analysis From 2012 To 2019

Author Type(s)

Faculty, Resident/Fellow

Document Type

Abstract

Publication Date

3-7-2023

DOI

10.1016/S0735-1097(23)01360-8

Journal Title

Journal of the American College of Cardiology

Department

Medicine

Abstract

ackground

Advancement in TAVR procedural techniques and operator experience has resulted in better patient outcomes over the years.

Methods

NRD 2012 to 2019 was queried to identify patients who underwent elective TAVR. The primary outcome was inpatient mortality during TAVR hospitalization. Secondary outcomes included periprocedural complications (acute kidney injury, bleeding requiring transfusion, pacemaker implantation, stroke), length of stay, hospitalization cost and 30-day readmission rate.

Results

283,409 patients who underwent TAVR were identified. The inpatient mortality during TAVR admissions declined significantly from 5.3% in 2012 to 0.0% in 2019 (p value for trend <0.001). Over the study period, there was a significant reduction in peri-TAVR occurrence of acute kidney injury, bleeding requiring transfusion, and stroke (p <0.001 for all). Periprocedural conduction abnormalities requiring permanent pacemaker implantation increased from 7.4% in 2012 to 12.1% in 2015, before decreasing to 8.9% in 2019. The mean length of hospital stay and inflation-adjusted costs during admission for TAVR decreased from 9.6 days and $64,695, to 3.6 days and $49,710, respectively (p <0.001). The 30-day readmission rate also reduced steadily from 18.2% to 11.5% (p <0.001).

Conclusion

Over the years, there has been a significant reduction in inpatient mortality, periprocedural complications, length of hospital stay, hospital costs, and 30-day readmission rate in patients undergoing TAVR.

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