Abstract 13731: 30-Days Readmission Rate, Mortality and Health Care Burden Among Patients Who Underwent Transcatheter Mitral Valve Repair With Co-Existing Atrial Fibrillation

Abstract

Introduction: Transcatheter mitral valve repair (TMVR) is a minimally invasive technique for the treatment of selected patients with symptomatic chronic moderate to severe mitral regurgitation (MR). Depending on the severity & chronicity of MR, there is left atrium remodeling in response to the volume overload, which contributes to the generation of atrial fibrillation (AF). Our study aimed to examine the 30-day readmission rates (30-DRr) among patients who underwent TMVR with co-existing AF in the United States. Methods: Using the 2017 National Readmission Database, we conducted a retrospective analysis of patient discharges with TMVR as a principal diagnosis and co-existing AF as a secondary diagnosis according to ICD-10 codes. Readmission was defined as the first admission to any hospital for any non-trauma diagnosis within 30 days of the index discharge. The primary outcome was 30-DRr, while secondary outcomes were readmission mortality rate, most common diagnoses for readmission, length of stay, hospitalization costs & patient charge. Results: A total of 3,242 Index admission with TMVR and AF; mean age 79.2years, & 53.3% male. In-hospital mortality rate was 2.46%, while all-cause readmission rate was 12%. Among this group of readmitted patients, the in-hospital mortality rate increased to 5.66% (aOR 2.38, adjusted p-value=0.009). The total hospital days associated with readmission were 2,244 days, with a total healthcare in-hospital economic burden of $6.24 million and total patient charge of 27 million. The most common diagnoses for readmission were hypertensive heart and chronic kidney disease with heart failure, hypertensive heart heart failure, Sepsis, AKI, Non-rheumatic MR &, AF, respectively. Conclusions: We observed among patient who underwent TMVR with co-existing AF, 1 in 8 was readmitted within 30-days with subsequent readmission associated with an increase in mortality and prolonged LOS, thus contributing to a significant economic burden.