| Autor: |
David J. Cohen, Yiran Zhang, Martin B. Leon, Vinod H. Thourani, Susheel Kodali, Scott Lilly, Satya Shreenivas, Michael J. Mack, Dean J. Kereiakes, Suzanne V. Arnold |
| Rok vydání: |
2021 |
| Předmět: |
|
| DOI: |
10.6084/m9.figshare.14632746.v2 |
| Popis: |
Background: Discharge patterns for patients following treatment of aortic stenosis with transcatheter (TAVR) or surgical aortic valve replacement (SAVR) are poorly defined and could impact long-term clinical outcomes. The objective is to define prevalence, predictors, and outcomes of patients discharged home versus other medical facility after either transcatheter or surgical aortic valve replacement. Methods: This is a retrospective analysis of the PARTNER 2 trial, which was a multicenter randomized trial of transcatheter versus surgical aortic valve replacement and associated registries. All patients that received either therapy and survived until discharge were included in the analysis. Two separate analyses were performed – one for those patients receiving TAVR and one for patients receiving SAVR. The primary outcome was two-year mortality in patients discharged home versus other medical facility. In addition, a prediction model was developed to predict discharge patterns following transcatheter or surgical aortic valve replacement. Results: 4,312 patients underwent TAVR and 22% (n= 958) were discharged to other medical facilities. 916 patients underwent SAVR and 52.4% (n = 480) were discharged to other medical facilities. Two-year mortality for patients undergoing aortic valve replacement and discharged to other medical facility versus home was 36.6% vs 18.0% in the TAVR group (p < 0.0001) and 19.7% vs 11.1% (p < 0.001) after SAVR. Patients discharged to other medical facility had worse quality of life and were more likely to be re-admitted after either procedure. Conclusion: After adjusting for risk factors that may be related to discharge location and death, discharge home versus discharge to other medical facility is associated with increased mortality and worse quality of life at 2 years following either TAVR or SAVR treatment of aortic stenosis. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
