Valvular & structural heart disease
Days at home after transcatheter or surgical aortic valve replacement in high-risk patients
Primary result · DAH365Result — go to the resultDifference 27.2 days 95% CI 6.0–48.5Authors' conclusion
In the U.S. CoreValve High Risk Trial linked to Medicare, high-risk patients undergoing TAVR spend an average of 27 additional DAH compared with SAVR in the first year after the procedure due to a shorter index LOS and the additive effect of fewer but nonsignificantly different mortality and total facility days after discharge from the index hospitalization compared with SAVR. After the first year, both groups spend a similar number of DAH.
Study context
- Population
- High-risk patients undergoing aortic valve replacement, Medicare-linked450 analysed at 1 year
- Participants
- 456 patients
- Comparison
- TAVR vs surgical aortic valve replacement (SAVR)
- TAVRn = 234
- SAVRn = 216reference
- Primary endpoint
- Days at home (DAH): days alive and outside hospital, skilled nursing facility, rehabilitation, long-term acute care hospital, ED or observation stay
- Follow-up
- 1 year (DAH365)
Methodological detailslinked to Medicare Fee-for-Service claims
- Linked to Medicare Fee-for-Service claims
Primary result
DAH (DAH365) · 1 year
Difference
27.2 days
95% CI 6.0–48.5
P = 0.01
By group
TAVR
295.1
mean · SD 106.9
SAVR
267.8
mean · SD 122.3
TAVRvs SAVR
difference 27.2 days (95% CI 6.0–48.5); P = 0.01
As reported in the abstract
Further findings
| Outcome | TAVR | SAVR | Difference, days | P value | |
|---|---|---|---|---|---|
| Index length of stay | 7.4 ± 4.5 | 12.5 ± 9.0 | −5.1 (CI −6.5 to −3.8) | P < 0.001 | |
| Mortality days (1 year) | 34.7 ± 93.1 | 48.0 ± 108.8 | −13.3 (95% CI −32.1 to 5.5) | P = 0.17 | |
| Total facility days after index discharge (1 year) | 27.9 ± 47.4 | 36.7 ± 48.9 | −8.8 (95% CI −17.8 to 0.1) | P = 0.05 | |
| DAH1825 · 5 years | mean 1154.2 ± 659.0 | mean 1067.6 ± 697.3 | 86.6 (95% CI −42.3 to 215.6) | P = 0.19 | |
| −1000100200300Difference, days (linear scale) |
| Outcome | TAVR | SAVR | P value |
|---|---|---|---|
| DAH years 1 to 5 (landmark analysis) | 1040.4 ± 477.5 | 1022.9 ± 489.3 | P = 0.74 |
- DAH1825: 427 analysed at 5 years (222 TAVR/205 SAVR)
Original publication
Days at home after transcatheter or surgical aortic valve replacement in high-risk patients. Am Heart J. Published 27 October 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →