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Original article

Vol. 149 No. 2526 (2019)

Determinants of hospital length of stay after transcatheter aortic valve implantation with self-expanding prostheses: a prospective, single centre observational study

  • Angela Frei
  • Dionysios Adamopoulos
  • Hajo Müller
  • Bernhard Walder
  • Nils Perrin
  • Thomas Reynaud
  • Sylvain Ho
  • Marco Roffi
  • François Mach
  • Marc-Joseph Licker
  • Stéphane Noble
DOI
https://doi.org/10.4414/smw.2019.20095
Cite this as:
Swiss Med Wkly. 2019;149:w20095
Published
30.06.2019

Summary

INTRODUCTION

We sought to identify baseline and periprocedural variables affecting hospital length of stay (LoS) in patients undergoing transcatheter aortic valve implantation (TAVI).

METHODS

Data on 304 consecutive patients undergoing TAVI at a single centre between August 2008 and December 2017 were collected prospectively. All patients underwent a complete clinical, echocardiographic and laboratory evaluation including a comprehensive frailty assessment at baseline. LoS was defined as the number of in-hospital days after the TAVI procedure during the index hospitalisation until the time the patient left the hospital for home or a rehabilitation clinic.

RESULTS

The mean LoS was 10.4 ± 7.1 days (median 8, interquartile range 5–12) with a significant trend towards shorter LoS over time (p <0.001). Patients discharged directly home were more likely to have shorter LoS (p = 0.007). All periprocedural complications were significantly associated with prolonged LoS (p <0.05 for all). Multivariate analysis showed an independent association between LoS and emergency admission (beta 3.24 ± 1.56, p = 0.039), baseline gait speed (beta: 0.39 ± 0.16, p = 0.018), baseline serum C-reactive protein (CRP, beta 0.14 ± 0.04, p = 0.001) and subclavian access (beta 8.27 ± 2 .9, p = 0.005). Gait speed and serum CRP remained significant determinants of LoS even after adjustment for periprocedural complications and patients’ discharge destination.

CONCLUSION

Baseline gait speed and serum CRP are significant independent determinants of LoS after TAVI.

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