Readmission After Surgical Aortic Valve Replacement in the United States
| Autor: | Yas Sanaiha, Peyman Benharash, Habib Khoury, Hannah Boutros, Sarah E. Rudasill, William S. Ragalie, Richard J. Shemin |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Databases Factual Psychological intervention MEDLINE Patient characteristics 030204 cardiovascular system & hematology Patient Readmission Transcatheter Aortic Valve Replacement 03 medical and health sciences Postoperative Complications 0302 clinical medicine Aortic valve replacement Health care medicine Humans Aged Adult patients business.industry Incidence (epidemiology) Aortic Valve Stenosis Length of Stay medicine.disease Quality Improvement 030228 respiratory system Emergency medicine Female Surgery Cardiology and Cardiovascular Medicine business Resource utilization |
| Zdroj: | The Annals of Thoracic Surgery. 110:849-855 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2019.11.058 |
| Popis: | Reducing inpatient readmissions is a national priority for improving healthcare quality and decreasing costs. Previous studies have shown that readmissions after surgical aortic valve replacement are frequent and contribute to increased healthcare costs, yet no studies have analyzed risk factors for readmission.The Nationwide Readmissions Database was used to identify adult patients undergoing surgical aortic valve replacement from 2010 to 2015. Incidence, patient characteristics, causes, resource utilization, and predictors of 30-day readmission were determined. International Classification of Diseases codes were used to capture surgical aortic valve replacement.Among 136,051 patients, 18,631 (13.7%) were readmitted within 30 days of discharge. Readmitted patients were more commonly women (47.4% vs 41.6%; P.001) and were older (70.4 years of age vs 68.3 years of age; P.001), with higher Elixhauser comorbidity index (5.4 vs 4.8; P.001), rates of postoperative complications (44.0% vs 37.3%; P.001), and greater length of stay (10.9 days vs 8.5 days; P.001). The mean cost of 1 readmission episode was $13,426. On multivariable analysis, significant predictors of readmission were female sex, age greater than 75 years, atrial fibrillation, chronic kidney and liver disease, and lower surgical aortic valve replacement hospital volume. A total of 49.1% of readmissions were related to cardiac causes, with heart failure (13.2%) and arrhythmia (12.5%) being the most common.Using a national inpatient database, we found readmission after surgical aortic valve replacement to be common and resource-intensive. Enhanced management of comorbidities and targeted postdischarge interventions for patients at high risk of readmission may help decrease healthcare utilization. |
| Databáze: | OpenAIRE |
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