Thirty‐day readmissions after transcatheter versus surgical mitral valve repair in high‐risk patients with mitral regurgitation: Analysis of the 2014–2015 Nationwide readmissions databases. Issue 3 (23rd December 2019)

• Record Type: Journal Article
• Authors: Lima, Fabio V.; Kolte, Dhaval; Rofeberg, Valerie; Molino, Janine; Zhang, Zheng; Elmariah, Sammy; Aronow, Herbert D.; Abbott, J. Dawn; Ben Assa, Eyal; Khera, Sahil; Gordon, Paul C.; Inglessis, Ignacio; Palacios, Igor F.
• Is Part Of: Catheterization and cardiovascular interventions. Volume 96:Issue 3(2020)
• Page Start: 664
• Page End: 674
• Publication Date: 2019-12-23
• Subjects: MitraClip -- Nationwide Readmission Database -- structural heart disease; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.28647
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Objective: Determine the rates, reasons, predictors, and costs of 30‐day readmissions following transcatheter mitral valve repair (TMVR) versus surgical mitral valve repair (SMVR) in the United States. Background: Data on 30‐day readmissions after TMVR are limited. Methods: High‐risk patients with mitral regurgitation (MR) undergoing TMVR or SMVR were identified from the 2014–2015 Nationwide Readmissions Databases. Multivariable stepwise regression models were used to identify independent predictors of 30‐day readmission. Risk of 30‐day readmission was compared between the two groups using univariate and propensity score adjusted regression models. Results: Among 8, 912 patients undergoing mitral valve repair during 2014–2015 (national estimate 17, 809), we identified 7, 510 (84.7%) that underwent SMVR and 1, 402 (15.3%) that underwent TMVR. Thirty‐day readmission rates after SMVR and TMVR were 10.7% and 11.7%, respectively (unadjusted OR 1.11, 95% CI 0.89–1.39, p = .35). After propensity score adjustment, TMVR was associated with a lower risk of 30‐day readmissions compared with SMVR (adjusted OR 0.70, 95% CI 0.51–0.95, p = .02). Heart failure and arrhythmias were the leading cardiac reasons for readmission. Anemia and fluid and electrolyte disorder were independent predictors of 30‐day readmission after TMVR. Demographics, comorbidities, and length of stay were independent predictors of 30‐day readmission after SMVR. Conclusions: One in 10 patients are readmitted within 30 days following TMVR or SMVR. Approximately half of the readmissions are for cardiac reasons. The predictors of 30‐day readmission are different among patients undergoing TMVR and SMVR, but can be easily screened for to identify patients at highest risk for readmission.