title: Early readmissions after transcatheter and surgical aortic valve replacement.
abstract: OBJECTIVE
  We aimed to determine and compare the prevalence, and predictors of readmissions after the transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR).
  
  
  BACKGROUND
  There are limited data on the readmission rates after TAVR in comparison with SAVR.
  
  
  METHODS
  We analyzed the data from 2013 National Readmission Database. Propensity-matched pairs were used to analyze differences in readmission rates between TAVR and SAVR for patients aged ≥65.
  
  
  RESULTS
  A total of 24,020 (TAVR-transfemoral 3,469, TAVR-transapical 1,433, SAVR 19,118) patients were included. The readmission rates were not statistically different for all propensity-matched TAVR and SAVR patients (17.2% vs. 20.6%, P = 0.28). However, in subgroup analysis, transapical TAVR had the highest readmission rate (22.8% vs. 16.5% vs. 16.0%, P < 0.001, respectively) and readmission leading to death (7.1% vs. 5.3% vs. 3.9%, P = 0.022, respectively) when compared with transfemoral TAVR and SAVR. In all the groups, two-thirds of readmissions were due to noncardiac causes. Congestive heart failure (CHF) and arrhythmia were the most frequent cardiac etiologies. The independent predictors of readmission were female sex, CHF, and chronic obstructive pulmonary disease. Patients who received care in teaching hospitals had lower probability of readmission.
  
  
  CONCLUSIONS
  One of six patients were readmitted within 30 days after the aortic valve replacement. On propensity score analysis, there were no significant differences between the early readmission rates between TAVR and SAVR groups. However, the patients undergoing transapical TAVR were at higher risk for readmission, and subsequent deaths when compared with transfemoral TAVR and SAVR. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Department of Cardiology, University of Texas McGovern School of Medicine, Houston, Texas.|Memorial Herman Heart and Vascular Center, Texas Medical Center, Houston, Texas.
authors.forename: Pimprapa
authors.identifier: http://orcid.org/0000-0002-4534-518X
authors.initials: P
authors.lastname: Vejpongsa
authors.affiliation: Department of Cardiology, University of Texas McGovern School of Medicine, Houston, Texas.|Department of management policy and community health, School of Public Health, University of Texas, Houston, Texas.
authors.forename: Viraj
authors.initials: V
authors.lastname: Bhise
authors.affiliation: Department of Cardiology, University of Texas McGovern School of Medicine, Houston, Texas.|Memorial Herman Heart and Vascular Center, Texas Medical Center, Houston, Texas.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Charitakis
authors.affiliation: Department of Cardiology, University of Texas McGovern School of Medicine, Houston, Texas.|Memorial Herman Heart and Vascular Center, Texas Medical Center, Houston, Texas.
authors.forename: H
authors.initials: H
authors.lastname: Vernon Anderson
authors.affiliation: Department of Cardiology, University of Texas McGovern School of Medicine, Houston, Texas.|Memorial Herman Heart and Vascular Center, Texas Medical Center, Houston, Texas.
authors.forename: Prakash
authors.initials: P
authors.lastname: Balan
authors.affiliation: Department of Cardiology, University of Texas McGovern School of Medicine, Houston, Texas.|Memorial Herman Heart and Vascular Center, Texas Medical Center, Houston, Texas.
authors.forename: Tom C
authors.initials: TC
authors.lastname: Nguyen
authors.affiliation: Department of Cardiology, University of Texas McGovern School of Medicine, Houston, Texas.|Memorial Herman Heart and Vascular Center, Texas Medical Center, Houston, Texas.
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Estrera
authors.affiliation: Department of Cardiology, University of Texas McGovern School of Medicine, Houston, Texas.|Memorial Herman Heart and Vascular Center, Texas Medical Center, Houston, Texas.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Smalling
authors.affiliation: Department of Cardiology, University of Texas McGovern School of Medicine, Houston, Texas.|Memorial Herman Heart and Vascular Center, Texas Medical Center, Houston, Texas.
authors.forename: Abhijeet
authors.initials: A
authors.lastname: Dhoble
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016009:Chi-Square Distribution; D016208:Databases, Factual; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010359:Patient Readmission; D057216:Propensity Score; D012307:Risk Factors; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects / Q000401:mortality; D016896:Treatment Outcome; D014481:United States
keywords: SAVR; TAVR; aortic stenosis; readmission; rehospitalization