Hospital variation of 30-day readmission rate following transcatheter aortic valve implantation. Issue 3 (24th February 2021)

• Record Type: Journal Article
• Authors: Ando, Tomo; Ashraf, Said; Kuno, Toshiki; Briasoulis, Alexandros; Takagi, Hisato; Grines, Cindy; Malik, Aaqib
• Is Part Of: Heart. Volume 108:Issue 3(2022)
• Page Start: 219
• Page End: 224
• Publication Date: 2021-02-24
• Subjects: transcatheter aortic valve replacement -- quality of health care -- aortic valve stenosis; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2020-318583
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objectives: Thirty-day readmission rate is one of the hospital quality metrics. Outcomes of transcatheter aortic valve implantation (TAVI) have improved significantly, but it remains unclear whether hospital-level variance in 30-day readmission rate exists in the contemporary TAVI era. Methods: From the 2017 US Nationwide Readmission Database, endovascular TAVI were identified. The unadjusted 30-day readmission rate and 30-day risk-standardised readmission rate (RSRR) were calculated and we then conducted model testing to determine the relative contribution of hospital characteristics, patient-level covariates and economic status to the variation in readmission rates observed between the hospitals. Results: A total of 44 899 TAVI from 338 hospitals were identified. The range of unadjusted 30-day readmission rate and 30-day RSRR was 2.0%–33.3% and 9.4%–15.3%, respectively. Median 30-day RSRR was 11.8% and there was a significant hospital-level variation (median OR 1.22, 95% CI 1.16 to 1.32, p<0.01) and this was similar in both readmissions caused due to major cardiac and non-cardiac conditions. Patient, hospital and economic factors accounted for 9.6%, 1.9% and 3.8% of the variability in hospital readmission rate, respectively. Conclusions: There was significant hospital-level variation in 30-day RSRR following TAVI. Further measures are required to mitigate this variance in the readmission rate.