Cardiovascular Outcomes of Hospital Frailty Index on Tavr and Associated Readmissions: A Nationwide Readmission Database Analysis
Author Type(s)
Resident/Fellow
Document Type
Abstract
Publication Date
2022
DOI
10.1016/j.jacc.2022.08.518
Journal Title
Journal of the American College of Cardiology
Department
Medicine
Abstract
Background: The hospital frailty index (FI) has been linked to worse outcomes, longer hospital admission, higher complications, and mortality. The impact of frailty on cardiovascular outcomes and hospital readmission post–transcatheter aortic valve replacement (TAVR) remains unknown. We conducted an FI-based comparison of the comorbidities, complications, outcomes, and readmission in patients post-TAVR. Methods: We conducted a retrospective weighted descriptive analysis of the Nationwide Readmission Database from 2012 to 2019 using International Classification of Diseases-10th Revision codes. Patients who underwent a TAVR procedure were identified and divided into low-intermediate risk frailty index (LFI) versus high-risk frailty index (HFI). The 2 groups were compared using STATA v17 (StataCorp LLC). Results: A total of 308,802 patients were identified, 301,950 (97.7%) of whom were LFI and 6,851 (2.21%) were HFI. The mean age was 79.7 and 82.3 years for LFI and HFI, respectively. Hypertension was the most common comorbidity in both groups (LFI = 80.50% vs HFI = 91.55%). Compared with the LFI, HFI was found to have higher readmission at 30, 90, and 180 days (P < 0.05). In-hospital mortality (1.9% vs 5.4%), acute kidney injury (14.6% vs 57.7%), heart failure (72.9% vs 82.5%), stroke (3.1% vs 12.6%), myocardial infarction (2.3% vs 7.8%), need for mechanical circulatory support (1.2% vs 3.3%), and major cardiac and cerebrovascular events (8.1% vs 28.7%) were all higher in the HFI group versus the LFI group (P < 0.05) (Figure). [Formula presented] Conclusion: We observed that HFI is associated with a significantly higher prevalence of in-hospital deaths, acute kidney injury, heart failure, stroke, myocardial infarction, mechanical circulatory support, and major cardiac and cerebrovascular events. Patients with HFI also had a significantly higher readmission rate. Categories: ENDOVASCULAR: Aortic Disease and Aortic Intervention
Recommended Citation
Titus, A., Sattar, Y., Fakhra, S., Erdem, S., Patel, N., Gill, D., Alyami, B., Pandya, K., Daggubatti, R., & Alraies, C. (2022). Cardiovascular Outcomes of Hospital Frailty Index on Tavr and Associated Readmissions: A Nationwide Readmission Database Analysis. Journal of the American College of Cardiology, 80 (12), B176-B177. https://doi.org/10.1016/j.jacc.2022.08.518
