Thirty-day readmissions in surgical and transcatheter aortic valve replacement: A systematic review and meta-analysis. (1st October 2018)

• Record Type: Journal Article
• Authors: Danielsen, Stein Ove; Moons, Philip; Sandven, Irene; Leegaard, Marit; Solheim, Svein; Tønnessen, Theis; Lie, Irene
• Is Part Of: International journal of cardiology. Volume 268(2018)
• Page Start: 85
• Page End: 91
• Publication Date: 2018-10-01
• Subjects: Surgical aortic valve replacement -- Transcatheter aortic valve replacement -- Aortic stenosis -- Thirty-day readmission; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2018.05.026
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: The 30-day all-cause readmission rate after surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) vary substantially. We conducted a systematic review and meta-analysis to examine the overall incidence, causes, and risk factors of 30-day all-cause readmission rate after SAVR and TAVR. Methods: Eight medical research databases were searched; Cochrane, Medline, Embase, UpToDate, PROSPERO, National Guideline Clearinghouse, SweMed and Oria. We followed The Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) for this study. Results: Thirty-three articles were included in the systematic review, 32 of which were appropriate for the meta-analysis. Overall, 17% (95% CI: 16–18%) of patients in the SAVR group, and 16% (95% CI: 15–18%) in the TAVR groups were readmitted within 30 days. Heart failure, arrhythmia, infection, and respiratory problems were the most frequent causes of all-cause readmission after SAVR and TAVR. Most frequent reported prior risk factors for all-cause readmission following TAVR were diabetes, chronic lung disease/chronic obstructive pulmonary disease, atrial fibrillation, kidney problems, and transapical approach/nonfemoral access. For SAVR, no risk factors for 30-day all-cause readmission were reported in the literature to date. Conclusion: In conclusion, the overall proportion of 30-day all-cause readmission after SAVR and TAVR are high. Interventions to prevent avoidable readmissions ought to be developed and implemented. Graphical abstract: Forest plots summarizing the proportions of 30-day all-cause readmission after surgical and transcatheter aortic valve replacement (SAVR and TAVR).