Work

Incidence, Predictors, and Outcomes of Patients Discharged Home Versus Other Medical Facility After Transcatheter or Surgical Aortic Valve Replacement

Year: 2021

Type: article

Abstract: Background Discharge patterns for patients following treatment of aortic stenosis with transcatheter (TAVR) or surgical aortic valve replacement (SAVR) are poorly defined and could impact long-term clinical outcomes. This study considers incidence, predictors, and outcomes of patients discharged home versus to another medical facility after either treatment.Methods This is a retrospective analysis of the multicenter randomized PARTNER 2 trial of transcatheter versus surgical aortic valve replacement and associated registries. All patients who received either therapy and survived until discharge were included in two separate analyses: one for patients receiving TAVR and one for patients receiving SAVR. The primary outcome was 2-year mortality after discharge home versus other medical facility. Also, a model was developed to predict discharge patterns following TAVR or SAVR.Results Of 4,312 patients who underwent TAVR, 22% (n = 958) were discharged to other medical facilities; 916 patients underwent SAVR and 52.4% (n = 480) were discharged to other medical facilities. Two-year mortality for patients undergoing aortic valve replacement and discharged to other medical facility versus home was 36.6% vs 18.0% after TAVR (p < 0.0001) and 19.7% vs 11.1% (p < 0.001) after SAVR. Patients discharged to another medical facility had worse quality of life and were more likely to be readmitted after either procedure.Conclusion After adjusting for risk factors that may relate to discharge location and death, discharge to other medical facility is associated with increased mortality and worse quality of life at 2 years following TAVR or SAVR treatment of aortic stenosis.

Source: Structural Heart

DOI: 10.1080/24748706.2021.1931735