Valvular & structural heart disease
Predictors and Variation in Cardiac Rehabilitation Participation After Transcatheter Aortic Valve Replacement
Authors' conclusion
Less than 1 in 3 patients who underwent TAVR in Michigan participated in CR within 90-days of discharge. Although several patient factors are associated with CR participation, hospital-level variation in CR participation after TAVR is not explained by patient case mix.
Study context
- Population
- Patients undergoing transcatheter aortic valve replacement (TAVR) at 24 Michigan hospitals, January 2016–June 2020
- Participants
- 3,372 patients
- Outcome
- CR participation (enrollment)
- Follow-up
- Within 90 days of discharge
Methodological detailsmulticentre, 24 Michigan hospitals, linked clinical and administrative claims data
- Multicentre
- 24 Michigan hospitals
- Linked clinical and administrative claims data
Main finding
As reported in the abstract
CR participation · within 90 days after discharge
Participated in cardiac rehabilitation (CR)
30.6%
Hospital variation in CR participation across 24 hospitals
5% to 60%
Observational data: associations, not effects.
Further findings
Patient factors associated with CR participation
- Negatively associated: older age, Medicaid insurance, AF/flutter, dialysis use, slower baseline 5-m walk times
Hospital variation explained by patient case mix
- Median OR before accounting for patient-level factors
- 2.11 (95% CI: 1.62-2.67)
- Median OR after accounting for patient-level factors
- 2.13 (95% CI: 1.61-2.68)
- Patient case mix did not explain hospital variation
Original publication
Predictors and Variation in Cardiac Rehabilitation Participation After Transcatheter Aortic Valve Replacement. JACC Adv. Published 16 September 2023. doi:10.
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