Analysis of disparities in length of hospital stay after transfemoral transcatheter aortic valve implantation: Results from the FRANCE TAVI (French Transcatheter Aortic Valve Implantation) Registry - 25/12/18
Résumé |
Introduction |
Transcatheter aortic valve implantation (TAVI) is playing a growing role in the management of patients with symptomatic severe aortic stenosis. However, length of hospital stay (LOS) after transfemoral (TF) TAVI remains widely variable among centers.
Purpose |
We aim to evaluate LOS after TF TAVI and its variability of LOS among French centers using data from the large national FRANCE TAVI registry.
Methods |
TAVI was performed in 12,804 patients in 48 French centers between January 2013 and December 2015 using TF approach in 87.2%. In-hospital mortality was 4.4%. Patients were discharged at home in 52.9%. LOS was evaluated in 5857 (45.7%) patients implanted via a TF approach and discharged at home.
Results |
The median of LOS in the overall studied population was 7 (5–9). The median of each center is shown in the figure. Centers were divided into two groups based on their median LOS value. Centers with a LOS median lower than 7 days constituted the “short” LOS centers group and centers with a LOS median of 7 days or higher constituted the “long” LOS centers group. The short LOS group (13 centers, 1559 patients) had a median LOS of 5 (4–7) days and the long LOS group (35 centers, 4298 patients) had a median LOS of 8 (6–10) days. There was no difference in baseline characteristics of patients between the two groups except for logistic EuroSCORE significantly lower in the short LOS group (15.5±10.5 vs. 17.1±11.0%, P<0.001). General anesthesia (48.0 vs. 26.9%, P<0.001) and self-expandable prosthesis (33.2 vs. 24.6%, P<0.001) were more frequently used in the long LOS group. Acute kidney injury stage 2–3 (2.5 vs. 1.5%, P=0.03) and conductive disorders requiring pacemaker (15.3 vs.11.4%, P<0.001) were more frequent in the long group.
Conclusions |
LOS remains high after TF TAVI in France and extremely variable among centers. Centers with a longer LOS more frequently used self-expandable prosthesis and general anesthesia with a higher rate of pacemaker.
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Vol 11 - N° 1
P. 64 - janvier 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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