PT  - JOURNAL ARTICLE
AU  - Tomo Ando
AU  - Said Ashraf
AU  - Toshiki Kuno
AU  - Alexandros Briasoulis
AU  - Hisato Takagi
AU  - Cindy Grines
AU  - Aaqib Malik
TI  - Hospital variation of 30-day readmission rate following transcatheter aortic valve implantation
AID  - 10.1136/heartjnl-2020-318583
DP  - 2021 Feb 23
TA  - Heart
PG  - heartjnl-2020-318583
4099  - http://heart.bmj.com/content/early/2021/02/24/heartjnl-2020-318583.short
4100  - http://heart.bmj.com/content/early/2021/02/24/heartjnl-2020-318583.full
AB  - Objectives Thirty-day readmission rate is one of the hospital quality metrics. Outcomes of transcatheter aortic valve implantation (TAVI) have improved significantly, but it remains unclear whether hospital-level variance in 30-day readmission rate exists in the contemporary TAVI era.Methods From the 2017 US Nationwide Readmission Database, endovascular TAVI were identified. The unadjusted 30-day readmission rate and 30-day risk-standardised readmission rate (RSRR) were calculated and we then conducted model testing to determine the relative contribution of hospital characteristics, patient-level covariates and economic status to the variation in readmission rates observed between the hospitals.Results A total of 44 899 TAVI from 338 hospitals were identified. The range of unadjusted 30-day readmission rate and 30-day RSRR was 2.0%–33.3% and 9.4%–15.3%, respectively. Median 30-day RSRR was 11.8% and there was a significant hospital-level variation (median OR 1.22, 95% CI 1.16 to 1.32, p<0.01) and this was similar in both readmissions caused due to major cardiac and non-cardiac conditions. Patient, hospital and economic factors accounted for 9.6%, 1.9% and 3.8% of the variability in hospital readmission rate, respectively.Conclusions There was significant hospital-level variation in 30-day RSRR following TAVI. Further measures are required to mitigate this variance in the readmission rate.