Predictors of Extended Postoperative Length of Stay After Uncomplicated Transcatheter Aortic Valve Replacement.
Aged
Aged, 80 and over
Aortic Valve Stenosis
/ diagnosis
Female
Humans
Hypertension, Pulmonary
/ epidemiology
Kidney Failure, Chronic
/ epidemiology
Length of Stay
/ statistics & numerical data
Male
Patient Admission
/ statistics & numerical data
Prognosis
Retrospective Studies
Risk Assessment
/ methods
Risk Factors
Sex Factors
Transcatheter Aortic Valve Replacement
/ methods
United States
/ epidemiology
low-risk TAVR
pulmonary hypertension
renal failure
Journal
The Journal of invasive cardiology
ISSN: 1557-2501
Titre abrégé: J Invasive Cardiol
Pays: United States
ID NLM: 8917477
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
entrez:
30
4
2019
pubmed:
30
4
2019
medline:
18
12
2019
Statut:
ppublish
Résumé
The current study aims to identify predictors of extended postoperative length of stay (PLOS) after uncomplicated transcatheter aortic valve replacement (TAVR). Patients who underwent TAVR at a single center between June 2012 and June 2016 were analyzed. Patients were stratified by time into an early cohort (EC; 2012-2014) and current cohort (CC; 2015-2016). Those who had complications post procedure were excluded. The CC group was dichotomized based on its median PLOS. Factors associated with a longer PLOS were investigated by using multivariable logistic regression analysis. Mean age of the 686 patients (299 in the EC group and 387 in the CC group) was 82 ± 8 years. PLOS in the CC group was significantly lower than in the EC group (4 days vs 6 days, respectively; P<.001). Median PLOS in the CC group was 2 days. Dichotomizing the CC group by median PLOS resulted in 148 patients (54%) ≤2 days vs 128 patients (46%) >2 days. Of these, PLOS was 1 day in 71 patients (26%) and 2 days in 61 patients (28%). Independent predictors of PLOS >2 days were non-transfemoral approach, non-elective admission, female sex, low mean transaortic gradient, presence of chronic renal failure, and pulmonary hypertension. Experience coupled with improvements in TAVR technology over the past few years have led to a significant decrease in PLOS after TAVR. In the current TAVR era, 1 out of every 2 patients stays for a day or two in the absence of perioperative adverse events.
Sections du résumé
BACKGROUND
BACKGROUND
The current study aims to identify predictors of extended postoperative length of stay (PLOS) after uncomplicated transcatheter aortic valve replacement (TAVR).
METHODS
METHODS
Patients who underwent TAVR at a single center between June 2012 and June 2016 were analyzed. Patients were stratified by time into an early cohort (EC; 2012-2014) and current cohort (CC; 2015-2016). Those who had complications post procedure were excluded. The CC group was dichotomized based on its median PLOS. Factors associated with a longer PLOS were investigated by using multivariable logistic regression analysis.
RESULTS
RESULTS
Mean age of the 686 patients (299 in the EC group and 387 in the CC group) was 82 ± 8 years. PLOS in the CC group was significantly lower than in the EC group (4 days vs 6 days, respectively; P<.001). Median PLOS in the CC group was 2 days. Dichotomizing the CC group by median PLOS resulted in 148 patients (54%) ≤2 days vs 128 patients (46%) >2 days. Of these, PLOS was 1 day in 71 patients (26%) and 2 days in 61 patients (28%). Independent predictors of PLOS >2 days were non-transfemoral approach, non-elective admission, female sex, low mean transaortic gradient, presence of chronic renal failure, and pulmonary hypertension.
CONCLUSION
CONCLUSIONS
Experience coupled with improvements in TAVR technology over the past few years have led to a significant decrease in PLOS after TAVR. In the current TAVR era, 1 out of every 2 patients stays for a day or two in the absence of perioperative adverse events.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM