| Title |
Early Versus Standard Discharge After Transcatheter Aortic Valve Replacement A Systematic Review and Meta-Analysis
|
|---|---|
| Published in |
JACC: Cardiovascular Interventions, September 2018
|
| DOI | 10.1016/j.jcin.2018.04.042 |
| Pubmed ID | |
| Authors |
Rafail A. Kotronias, Michael Teitelbaum, John G. Webb, Darren Mylotte, Marco Barbanti, David A. Wood, Brennan Ballantyne, Alyson Osborne, Karla Solo, Chun Shing Kwok, Mamas A. Mamas, Rodrigo Bagur |
| Abstract |
This study sought to assess the clinical outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) with early discharge (ED) versus standard discharge (SD) pathways. Minimalist approaches for TAVR have been developed targeting different aspects of the procedure such as local anesthesia or sedation, intraprocedural imaging, vascular access, post-operative monitoring and care, and discharge planning. Their incorporation into routine clinical practice aims to reduce length of hospital stay and health care cost utilization without adversely affecting outcomes when compared with standard approaches. The authors conducted a search of MEDLINE and EMBASE to identify studies that investigated ED (≤3 days) versus SD in TAVR patients. Random-effects meta-analyses were used to estimate the effect of ED compared with SD with regard to 30-day mortality after discharge, 30-day readmission rate, and need for permanent pacemaker implantation (PPI) following discharge. Eight studies including 1,775 participants (ED, n = 642) fulfilled the inclusion criteria. The mean age was 82.4 years and STS score was 6.7. Meta-analyses evaluating discharge to 30-day mortality (odds ratio [OR]: 0.65; 95% confidence interval [CI]: 0.23 to 1.82; I2 = 0%) and discharge to 30-day new PPI (OR: 1.61; 95% CI: 0.19 to 13.71; I2 = 40%) showed no significant difference in an ED compared with a SD strategy. Notably, ED patients were less likely to be readmitted after ED when compared with SD patients (OR: 0.63; 95% CI: 0.41 to 0.98; p = 0.04, I2 = 0%). ED following uncomplicated TAVR is safe in terms of discharge to 30-day mortality or need for PPI following discharge. Moreover, ED patients experienced a lower rate of readmissions. These data support the safety of programs aiming an ED pathway in selected TAVR patients. Institutional protocols with the input from different members of the multidisciplinary heart team should be devised to optimize discharge processes to improve health care resource utilization. |
X Demographics
The data shown below were collected from the profiles of 78 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 21 | 27% |
| United Kingdom | 6 | 8% |
| Canada | 4 | 5% |
| Argentina | 4 | 5% |
| France | 3 | 4% |
| Mexico | 2 | 3% |
| Spain | 2 | 3% |
| Pakistan | 1 | 1% |
| Dominican Republic | 1 | 1% |
| Other | 12 | 15% |
| Unknown | 22 | 28% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 50 | 64% |
| Scientists | 14 | 18% |
| Science communicators (journalists, bloggers, editors) | 8 | 10% |
| Practitioners (doctors, other healthcare professionals) | 6 | 8% |
Mendeley readers
The data shown below were compiled from readership statistics for 76 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 76 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 10 | 13% |
| Other | 8 | 11% |
| Student > Bachelor | 8 | 11% |
| Student > Master | 7 | 9% |
| Student > Doctoral Student | 5 | 7% |
| Other | 11 | 14% |
| Unknown | 27 | 36% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 29 | 38% |
| Nursing and Health Professions | 4 | 5% |
| Agricultural and Biological Sciences | 2 | 3% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Chemistry | 2 | 3% |
| Other | 10 | 13% |
| Unknown | 27 | 36% |
Attention Score in Context
This research output has an Altmetric Attention Score of 45. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 July 2020.
All research outputs
#927,865
of 25,385,509 outputs
Outputs from JACC: Cardiovascular Interventions
#307
of 4,032 outputs
Outputs of similar age
#19,769
of 345,739 outputs
Outputs of similar age from JACC: Cardiovascular Interventions
#6
of 86 outputs
Altmetric has tracked 25,385,509 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,032 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 15.2. This one has done particularly well, scoring higher than 92% of its peers.
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We're also able to compare this research output to 86 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 93% of its contemporaries.