title: Thirty-Day Readmissions After Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis in New York State.
abstract: BACKGROUND
  Several studies have compared short-term and medium-term mortality rates for patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR), but no studies have compared short-term readmission rates for the 2 procedures.
  
  
  RESULTS
  New York's Cardiac Surgery Reporting System was used to propensity match 617 TAVI and 1981 SAVR patients using numerous patient risk factors contained in the registry. The 389 propensity-matched pairs were then used to analyze differences in readmission rates between the 2 groups. TAVI and SAVR readmission rates were also compared for patients with a history of congestive heart failure and for patients aged ≥80. Also, reasons for readmission for TAVI and SAVR patients were examined and compared. Readmission rates were not statistically different for all propensity-matched TAVI and SAVR patients (respective rates, 18.8% and 19.3%; P=0.86). After further adjustment using a logistic regression model, there was still no significant difference (adjusted odds ratio, 0.97; 95% confidence interval [0.68-1.39]). For patients aged ≥80, the 30-day readmission rates were 19.9% and 22.0% (P=0.59), and when further adjusted using the logistic regression model, adjusted odds ratio=0.89 (0.55-1.45). For patients with a history of congestive heart failure, the respective rates were 22.8% and 20.4% (P=0.56), and with further adjustment, adjusted odds ratio became 1.15 (0.72-1.82).
  
  
  CONCLUSIONS
  There are no statistically significant differences between TAVI and SAVR patients in short-term readmission rates.
authors.affiliation: From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.). elh03@health.state.ny.us.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Hannan
authors.affiliation: From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.).
authors.forename: Zaza
authors.initials: Z
authors.lastname: Samadashvili
authors.affiliation: From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.).
authors.forename: Desmond
authors.initials: D
authors.lastname: Jordan
authors.affiliation: From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.).
authors.forename: Thoralf M
authors.initials: TM
authors.lastname: Sundt
authors.affiliation: From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.).
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Stamato
authors.affiliation: From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.).
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Lahey
authors.affiliation: From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.).
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Gold
authors.affiliation: From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.).
authors.forename: Andrew
authors.initials: A
authors.lastname: Wechsler
authors.affiliation: From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.).
authors.forename: Mohammed H
authors.initials: MH
authors.lastname: Ashraf
authors.affiliation: From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.).
authors.forename: Carlos
authors.initials: C
authors.lastname: Ruiz
authors.affiliation: From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.).
authors.forename: Sean
authors.initials: S
authors.lastname: Wilson
authors.affiliation: From the School of Public Health, University at Albany, State University of New York, Albany (E.L.H., Z.S.); Department of Anesthesiology (D.J.) and Department of Surgery (C.R.S.), Columbia-Presbyterian Medical Center, New York, NY; Heart Center and Institute for Heart, Vascular and Stroke, Massachusetts General Hospital, Boston (T.M.S.); Department of Cardiology, Campbell County Memorial Hospital, Gillette, WY (N.J.S.); Division of Cardiothoracic Surgery, University of Connecticut, Storrs (S.J.L.); University of Nebraska Medical Center, Omaha (J.P.G.); Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA (A.W.); Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, NY (M.H.A.); Division of Structural and Congenital Heart Disease, Lenox Hill Hospital, New York, NY (C.R.); and Department of Surgery, The Valley Hospital, Ridgewood, NJ (S.W.).
authors.forename: Craig R
authors.initials: CR
authors.lastname: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011159:Population Surveillance; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*
keywords: aortic valve stenosis; heart failure; patient readmission; risk factors; transcatheter aortic valve replacement