title: Influence of same-day admission on outcomes following transcatheter aortic valve replacement.
abstract: BACKGROUND
  Since elective transcatheter aortic valve replacements (TAVRs) can be performed on the day of admission, i.e., Day 0, or on the next day of admission, i.e., Day 1, we sought to investigate if there is an advantage to either approach.
  
  
  METHODS
  We performed a retrospective cohort study, using the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample database of 2012 and identified subjects undergoing endovascular (Transfemoral/Transaortic) TAVRs using the ICD-9-CM procedure code of 35.05. The cohort was divided based on the day of the TAVR performed, i.e., Day 0 or 1. The cost of the hospitalization and length of stay were the primary outcomes, with in-hospital mortality and procedural complications as the secondary outcomes. We identified a total of 843 TAVRs. Propensity matched models were created. The mean age of the study cohort was 82 years.
  
  
  RESULTS
  In a propensity-matched dataset, TAVRs performed on Day 0 were associated with a lower cost ($51,126 ± 1184 vs $57,703 ± 1508, p < 0.0001) and length of stay (mean days, standard error: 5.87 ± 0.25 vs 7.20 ± 0.29, p < 0.001) compared to Day 1. In-hospital mortality plus complication rates were relatively similar with no difference between Days 0 and 1 (31.5% vs 34.1%, p = 0.47, respectively).
  
  
  CONCLUSIONS
  Endovascular TAVRs performed on the same day of admission are associated with lower hospitalization costs and length of stay, and similar mortality and complication rates compared to those performed on the next day of admission.
authors: Department of Internal Medicine, Western Reserve Health Education, Youngstown, Ohio.
authors: Samir V
authors: SV
authors: Patel
authors: Department of Cardiology, The Everett Clinic, Everett, Washington.
authors: Sunny
authors: S
authors: Jhamnani
authors: Department of Internal Medicine, Western Reserve Health Education, Youngstown, Ohio.
authors: Palak
authors: P
authors: Patel
authors: Department of Internal Medicine, Brandon Regional Hospital, Brandon, Florida.
authors: Rajesh
authors: R
authors: Sonani
authors: Department of Internal Medicine, New York Medical College, Valhalla, New York.
authors: Chirag
authors: C
authors: Savani
authors: Department of Internal Medicine, Saint Peter's University Hospital, New Brunswick, New Jersey.
authors: Nilay
authors: N
authors: Patel
authors: Department of Cardiology, Borgess Medical Center, Kalamazoo, Michigan.
authors: Nileshkumar J
authors: NJ
authors: Patel
authors: Department of Cardiology, University of Miami Miller School of Medicine, Miami, Florida.
authors: Sidakpal S
authors: SS
authors: Panaich
authors: Department of Internal Medicine, Christus Highland Medical Center, Shreveport, Louisiana.
authors: Mihir
authors: M
authors: Patel
authors: Department of Cardiology, Detroit Medical Center, Detroit, Michigan.
authors: Schreiber
authors: S
authors: Theodore
authors: Department of Cardiology, Detroit Medical Center, Detroit, Michigan.
authors: Cindy
authors: C
authors: Grines
authors: Department of Cardiology, The Everett Clinic, Everett, Washington. apurva_badheka@yahoo.com.
authors: Apurva O
authors: AO
authors: Badheka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000191:economics / Q000401:mortality / Q000601:surgery*; D006328:Cardiac Catheterization / Q000191:economics / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D017721:Hospital Costs / Q000639:trends; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D010343:Patient Admission; D057216:Propensity Score; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000191:economics / Q000379:methods*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology