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40
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Text
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URL Address
<a href="http://doi.org/" target="_blank" rel="noreferrer noopener">http://doi.org/</a>
Pages
64-72
Issue
3
Volume
31
ISSN
1557-2501 1042-3931
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Update Year & Number
June2020SubmittedList
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Internal Medicine
Affiliated Hospital
Cleveland Clinic Akron General Hospital
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Feasibility and safety of adopting next-day discharge as first-line option after transfemoral transcatheter aortic valve replacement.
Publisher
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The Journal of invasive cardiology
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-03
Subject
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Female; Humans; Male; Aged; Retrospective Studies; Cohort Studies; Follow-Up Studies; Severity of Illness Index; Time Factors; United States; Aged 80 and over; Survival Analysis; Patient Readmission/statistics & numerical data; Propensity Score; Ohio; Academic Medical Centers; Risk Assessment; Feasibility Studies; Patient Discharge; aortic stenosis; transcatheter aortic valve replacement; Length of Stay; early discharge; minimalist approach; next-day discharge; Patient Safety; Aortic Valve Stenosis/diagnosis/surgery; Transcatheter Aortic Valve Replacement/methods/mortality
Creator
An entity primarily responsible for making the resource
Ichibori Y; Li J; Davis A; Patel TM; Lipinski J; Panhwar M; Saric P; Qureshi G; Patel SM; Sareyyupoglu B; Markowitz AH; Bezerra HG; Costa MA; Zidar DA; Kalra A; Attizzani GF
Description
An account of the resource
OBJECTIVES: Data on next-day discharge (NDD) after transcatheter aortic valve replacement (TAVR) are limited. This study investigated the feasibility and safety of NDD as a first-line option (the very-early discharge [VED] strategy) compared with the early-discharge (ED) strategy (2-3 days as a first-line option) after TAVR. METHODS: We reviewed 611 consecutive patients who had minimalist TAVR (transfemoral approach under conscious sedation) and no in-hospital mortality; a total of 418 patients underwent ED strategy (since December 2013) and 193 patients underwent VED strategy (as part of a hospital initiative to reduce length of stay, since August 2016). NDD in the VED strategy was performed with heart team consensus in patients without significant complications. The primary outcome was a composite of 30-day all-cause mortality/rehospitalization. RESULTS: Sixty-five patients (33.7%) in the VED strategy and 10 patients (2.4%) in the ED strategy were discharged the next day (P<.001). NDD patients had received balloon-expandable (n = 30) or self-expanding valves (n = 45) and showed a similar primary outcome rate compared with non-NDD patients. After adjustment using propensity score matching (172 pairs), post-TAVR length of stay was significantly shorter in the VED group (3.2 ± 3.1 days) than in the ED group (3.5 ± 2.7 days; P<.01). The primary outcome did not differ between the two groups (7.0% vs 11.6%; P=.14), with comparable 30-day mortality rate (1.2% vs 2.3%; P=.68) and rehospitalization rate (5.8% vs 11.1%; P=.08). CONCLUSIONS: Utilization of NDD as a first-line option after minimalist TAVR is feasible and safe, and leads to further reduction in length of stay compared with an ED strategy.
Identifier
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<a href="http://doi.org/" target="_blank" rel="noreferrer noopener"></a>
PMID: 30819977
Rights
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© 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.
Format
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journalArticle
2019
Academic Medical Centers
Aged
Aged 80 and over
aortic stenosis
Aortic Valve Stenosis/diagnosis/surgery
Attizzani GF
Bezerra HG
Cleveland Clinic Akron General Hospital
Cohort Studies
Costa MA
Davis A
Department of Internal Medicine
early discharge
Feasibility Studies
Female
Follow-Up Studies
Humans
Ichibori Y
journalArticle
June2020SubmittedList
Kalra A
Length of Stay
Li J
Lipinski J
Male
Markowitz AH
minimalist approach
NEOMED College of Medicine
next-day discharge
Ohio
Panhwar M
Patel SM
Patel TM
Patient Discharge
Patient Readmission/statistics & numerical data
Patient Safety
Propensity Score
Qureshi G
Retrospective Studies
Risk Assessment
Sareyyupoglu B
Saric P
Severity of Illness Index
Survival Analysis
The Journal of invasive cardiology
Time Factors
transcatheter aortic valve replacement
Transcatheter Aortic Valve Replacement/methods/mortality
United States
Zidar DA