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MitraClip 30-Day Readmissions and Impact of Early Discharge: An Analysis from the Nationwide Readmissions Database 2016.

by Ben-Dor, Itsik; Case, Brian C; Forrestal, Brian J; Hahm, Joshua; Musallam, Anees; Rogers, Toby; Satler, Lowell F; Torguson, Rebecca; Waksman, Ron; Wang, Yanying; Yerasi, Charan.
Citation: Cardiovascular Revascularization Medicine. 21(8):954-958, 2020 08.; .Journal: Cardiovascular revascularization medicine : including molecular interventions.Published: 2020; ; ; ISSN: 1878-0938.Full author list: Ben-Dor I; Case BC; Forrestal BJ; Hahm J; Musallam A; Rogers T; Satler LF; Torguson R; Waksman R; Wang Y; Yerasi C.UI/PMID: 32299725.Subject(s): *Heart Valve Prosthesis | *Heart Valve Prosthesis Implantation/is [Instrumentation] | *Length of Stay | *Mitral Valve Insufficiency/su [Surgery] | *Mitral Valve/su [Surgery] | *Patient Discharge | *Patient Readmission | Aged | Aged, 80 and over | Databases, Factual | Feasibility Studies | Female | Heart Valve Prosthesis Implantation/ae [Adverse Effects] | Heart Valve Prosthesis Implantation/td [Trends] | Humans | Length of Stay/td [Trends] | Male | Mitral Valve Insufficiency/dg [Diagnostic Imaging] | Mitral Valve Insufficiency/pp [Physiopathology] | Mitral Valve/dg [Diagnostic Imaging] | Mitral Valve/pp [Physiopathology] | Patient Discharge/td [Trends] | Patient Readmission/td [Trends] | Prosthesis Design | Risk Assessment | Risk Factors | Time Factors | Treatment Outcome | United StatesInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1016/j.carrev.2020.04.004 (Click here) Abbreviated citation: Cardiovasc Revasc Med. 21(8):954-958, 2020 08; .Local Holdings: Available in print through MWHC library: 2002 - present.Abstract: BACKGROUND/PURPOSE: Edge-to-edge mitral valve repair (MVR) using the MitraClip (Abbott Vascular, Santa Clara, CA), is now labeled for patients with degenerative and functional mitral regurgitation. Because this is a minimally invasive transcatheter procedure, patients are commonly discharged early post-procedure, yet rates and causes of early readmissions are unknown. This study aimed to evaluate underlying causes and trends of 30-day readmissions using the 2016 US Nationwide Readmissions Database (NRD) in patients discharged early after MVR with MitraClip.Abstract: CONCLUSIONS: Early discharge post-MitraClip treatment is feasible, safe, and associated with low readmission rates as compared to all MitraClip procedures performed. Special considerations for early discharge should apply to postprocedural complications and patients with heart failure, the most common readmission causes, as these may require longer stays post-procedure.Abstract: METHODS/MATERIALS: We identified all patients who received a MitraClip in 2016 and then identified a cohort of patients who were discharged early (<48 h). Next, any admission within 30 days of the index procedure was identified.Abstract: RESULTS: Our analysis included 3858 MitraClip patients. The overall 30-day readmission rate was 13.5%. A total of 2341 patients (61%) were discharged early. The readmission rate among the early discharge cohort was 10.1% (233/2314). The readmission rate among the early discharge cohort was 10.1% (233/2314). The major causes of readmission were heart failure (27.5%), infections (15.5%), and postprocedural complications (6.9%).Abstract: SUMMARY: This study aimed to evaluate underlying causes and trends of 30-day readmissions using the US Nationwide Readmissions Database (NRD) 2016 dataset in patients discharged early after mitral valve repair with MitraClip. The overall 30-day readmission rate during this period was 13.5%; the readmission rate among patients discharged early (<48 h) was 10.1%. Early discharge post-MitraClip treatment is feasible and safe and is associated with low readmission rates. Copyright (c) 2020. Published by Elsevier Inc.

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