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05.12.2019 | Review articles

Causes and predictors of readmission after transcatheter aortic valve implantation

A meta-analysis and systematic review

verfasst von: Yi-ming Li, MD, Fu-yang Mei, MD, Yi-jun Yao, MB, Jia-yu Tsauo, MD, Yong Peng, MD, Mao Chen, MD, PhD

Erschienen in: Herz | Sonderheft 1/2021

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Abstract

Background

Since readmission rate is an important clinical index to determine the quality of inpatient care and hospital performance, the aim of this study was to explain the causes and predictors of readmission following transcatheter aortic valve implantation (TAVI) at short-term and mid-term follow-up.

Methods and results

A systematic review and meta-analysis of all published articles from Embase, Pubmed/MEDLINE, and Ovid was carried out. In all, 10 studies including 52,702 patients were identified. The pooled estimate for the overall event rate was 0.15, and cardiovascular causes were the main reason for 30-day readmission (0.42, 95% confidence interval [CI]: 0.39–0.45). In addition, the pooled incidence of 1‑year readmission was 0.31, and cardiovascular events were still the main cause (0.41, 95% CI: 0.33–0.48). Patients with major and life-threatening bleeding, new permanent pacemaker implantation, and clinical heart failure were associated with a high risk for early readmission after TAVI. Moreover, an advanced (≥3) New York Heart Association classification, acute kidney injury, paravalvular leak, mitral regurgitation (≥ moderate), and major bleeding predicted unfavorable outcome to 1‑year readmission. Female gender and transfemoral TAVI was associated with a lower risk for unplanned rehospitalization.

Conclusions

This meta-analysis found cardiovascular factors to be the main causes for both 30-day and 1‑year rehospitalization. Heart failure represented the most common cardiovascular event at both short-term and mid-term follow-up. Several baseline characteristics and procedure-related factors were deemed unfavorable predictors of readmission. Importantly, transfemoral access and female gender were associated with a lower risk of readmission.

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Titel: Causes and predictors of readmission after transcatheter aortic valve implantation
A meta-analysis and systematic review
verfasst von: Yi-ming Li, MD
Fu-yang Mei, MD
Yi-jun Yao, MB
Jia-yu Tsauo, MD
Yong Peng, MD
Mao Chen, MD, PhD
Publikationsdatum: 05.12.2019
Verlag: Springer Medizin
Erschienen in: Herz / Ausgabe Sonderheft 1/2021
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-019-04870-6

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