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

Article Article scientifique Article Determinants of hospital length of stay after transcatheter aortic valve implantation with self-expanding prostheses: a prospective, single centre observational study eng 2019-06-30 2019-06-30 author Frei Angela Division of Cardiology, University Hospital of Geneva, Switzerland author Adamopoulos Dionysios Division of Cardiology, University Hospital of Geneva, Switzerland 930516 Département de médecine (DEMED) author Mueller Hajo 0000-0001-9366-9499 Division of Cardiology, University Hospital of Geneva, Switzerland 89204 Département de médecine (DEMED) author Walder Bernhard Division of Anaesthesiology, University Hospital of Geneva, Switzerland 124875 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) author Perrin Nils Division of Cardiology, University Hospital of Geneva, Switzerland 660226 author Reynaud Thomas Division of Anaesthesiology, University Hospital of Geneva, Switzerland 709589 author Ho Sylvain Department of Nutrition and Dietetics, University Hospital of Geneva, Switzerland author Roffi Marco Division of Cardiology, University Hospital of Geneva, Switzerland 669427 Département de médecine (DEMED) author Mach François Division of Cardiology, University Hospital of Geneva, Switzerland 27365 Département de médecine (DEMED) author Licker Marc Division of Anaesthesiology, University Hospital of Geneva, Switzerland 133428 Décanat et administration de la faculté de médecine (ADMED) author Noble Stéphane Laurent 0000-0002-8018-2857 Division of Cardiology, University Hospital of Geneva, Switzerland 87673 Département de médecine (DEMED) w20095 10.4414/smw.2019.20095 31256415 1424-3997 https://doi.emh.ch/smw.2019.20095 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. Aged, 80 and over Echocardiography Female Hospitalization Humans Length of Stay / statistics & numerical data Male Patient Discharge / statistics & numerical data Prospective Studies Prostheses and Implants Transcatheter Aortic Valve Replacement Dewey 616 Dewey 617 56 Département de médecine 221 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 false 218 Dysfonctions cardio-pulmonaires et cérébrales 278 Swiss medical weekly 149 2526 a99963d2-c093-4dbc-b86f-9ed9a19c4aa0 Article (Published version) Public smw_2019_20095 (1).pdf 874521 application/pdf CC BY-NC-ND-4.0 2764a580e9bc19fe3d6226c1e84f8e0166bd8cb952806f7eaa0a03c9ba86117a openAccess Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences

Title	Published in	Year	Views	Downloads

Determinants of hospital length of stay after transcatheter aortic valve implantation with self-expanding prostheses: a prospective, single centre observational study	Swiss medical weekly	2019	105	212
Patient and procedural features predicting early and mid-term outcome after radical surgery for non-small cell lung cancer	Journal of Thoracic Disease	2018	291	1

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Reynaud, Thomas