Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jul 26, 2024; 16(7): 402-411
Published online Jul 26, 2024. doi: 10.4330/wjc.v16.i7.402
Rates, predictors, and causes of readmission after transcatheter aortic valve replacement in patients with chronic kidney disease
Taha Teaima, Gianfranco Bittar Carlini, Rohan A Gajjar, Imran Aziz, Sami J Shoura, Abdul-Rahim Shilbayeh, Naim Battikh, Tareq Alyousef
Taha Teaima, Gianfranco Bittar Carlini, Rohan A Gajjar, Imran Aziz, Sami J Shoura, Abdul-Rahim Shilbayeh, Naim Battikh, Tareq Alyousef, Division of Cardiology, Department of Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, United States
Author contributions: Teaima T and Alyousef T conceptualized the research idea and designed the study; Teaima T curated data from database and performed statistical anylysis, Gajjar RA contributed with data analysis; Teaima T, Carlini GB, Gajjar RA, Aziz I, Shoura SJ wrote the original manuscript draft; Shilbayeh AR and Battikh N contributed with manuscript review and further editing; Teaima T and Alyousef T supervised all the tasks. All authors have read and approve the final manuscript.
Institutional review board statement: This manuscript is exempt from Institutional Review Board approval, as national readmission database is a de-identified national administrative database and is readily available online at https://www.hcup-us.ahrq.gov.
Informed consent statement: National readmission database is a de-identified national administrative database and is readily available online no informed consent was required.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: National readmission database is a de-identified national administrative database and is readily available online at https://www.hcup-us.ahrq.gov.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tareq Alyousef, MD, Staff Physician, Department of Cardiology, John H. Stroger, Jr. Hospital of Cook County, 1969 W Ogden Ave, Chicago, IL 60612, United States. talyousef@cookcountyhhs.org
Received: February 13, 2024
Revised: May 9, 2024
Accepted: June 6, 2024
Published online: July 26, 2024
Processing time: 161 Days and 19.5 Hours
Abstract
BACKGROUND

Transcatheter aortic valve replacement (TAVR) is a revolutionary procedure for severe aortic stenosis. The coexistence of chronic kidney disease (CKD) and TAVR introduces a challenge that significantly impacts patient outcomes.

AIM

To define readmission rates, predictors, and causes after TAVR procedure in CKD stage 1-4 patients.

METHODS

We used the national readmission database 2018 and 2020 to look into readmission rates, causes and predictors after TAVR procedure in patients with CKD stage 1-4.

RESULTS

Out of 24758 who underwent TAVR and had CKD, 7892 (32.4%) patients were readmitted within 90 days, and had higher adjusted odds of being females (adjusted odds ratio: 1.17, 95%CI: 1.02-1.31, P = 0.02) with longer length of hospital stay > 6 days, and more comorbidities including but not limited to diabetes mellitus, anemia, and congestive heart failure (CHF).

CONCLUSION

Most common causes of readmission included CHF (18.0%), sepsis, and complete atrioventricular block. Controlling readmission predictors with very close follow-up is warranted to prevent such high rate of readmission.

Keywords: Chronic kidney disease; Transcatheter aortic valve replacement; Readmission; Predictors; Rates

Core Tip: Our analysis of national readmission database for year 2018 to 2020 for 90 days readmissions for patients with chronic kidney disease stage 1-4 undergoing transcatheter aortic valve replacement showed considerably higher readmission rate to 32.4%. Majority were females and had higher comorbidity burden. Most common cause of 90 days readmission was congestive heart failure. Hence, we recommend optimization of co-morbidities and close follow up after index admission to prevent high rate of readmissions.