Same-day discharge after TAVI is safe for low-risk patients, resulting in significant cost savings

According to new results published in the American Journal of Cardiology.[1]

“Studies have demonstrated that early and even next-day discharge of some patients who have undergone modern minimalist TAVR is safe and feasible without an increased risk of complications,” the first author wrote. Akshay Goel, MDof Westchester Medical Center in Valhalla, New York, and his colleagues. “Whether accelerating discharge after TAVR further by allowing SDD in selected patients is safe or derives additional benefit remains unanswered.”

Goel et al. reviewed data from the National Readmission Databaseinvolving more than 196,000 TAVI patients treated from 2015 to 2019. The average patient age was 79.5 years and 55% of patients were male.

“This is by far the largest analysis of TAVR patients to date that we are aware of,” the group wrote.

While 245 patients (0.12%) were discharged on the same day, the remaining patients were all discharged on a different day. The median length of stay for patients who received a different day discharge (DDD) was two days. Median hospitalization costs were “significantly lower” for SDD patients ($37,800) than for DDD patients ($49,100).

SDD patients tended to be slightly younger than DDD patients, the authors added, and were less likely to have a history of stroke. Furthermore, 36.8% of SDD patients were female, but 45% of DDD patients were female.

Propensity score matching was performed to compare outcomes between the two groups. The 30-day readmission rate was 11% for TAVI patients discharged the same day and 10.6% for DDD patients.

The researchers also focused on some of the potential benefits and risks associated with post-TAVR SDD.

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