B-35 | Recent Trends in Same Day Discharge Post Transcatheter Aortic Valve Replacement: A 5 year Analysis of the National Inpatient Sample

Abstract

Transcatheter aortic valve replacement (TAVR) is one of the recommended interventions for patients with symptomatic aortic stenosis. Same-day discharge (SDD) prevents increased hospital length of stay, reduces infection rates, and improves the overall health of patients. SDD post-TAVR has been found to be safe and feasible among carefully selected patients. This study examines the recent trend in SDD post-TAVR among hospitalized patients in the United States. Using the International Classification of Diseases, 10th edition, Clinical Modification (ICD-10-CM) procedure codes, we queried the National Inpatient Sample 2016 to 2020 for hospitalizations among patients who had a transcatheter aortic valve replacement as a primary procedure. SDD post-TAVR was defined as a stay after a TAVR procedure that did not involve overnight monitoring (length of stay < 1 day). Demographic characteristics were compared between SDD and non-SDD. Trends in SDD after TAVR was described for the years 2016 to 2020. This study included 58,125 hospitalizations for TAVR between 2016 to 2020, of which 53.1% were males, and 46.9% were females. There was no statistically significant difference in the mean age among patients with SDD post-TAVR compared to non- SDD post-TAVR [mean age ± S.D: 78.9 ± 8.4 vs. 78.9 ± 8.5 (P=0.95)]. SDD was observed among 271 (0.47%) out of 58,125 hospitalizations during the study period. Our analysis revealed an increasing trend in the proportion of patients with an SDD after a TAVR from 0.29% in 2016 to 0.76% in 2020 (p<.0001), with the most significant increase occurring between 2019 and 2020 (0.41% in 2019 vs. 0.76% in 2020). Compared to non-SDD, patients with SDD reported an average savings of $28,100 during the study period. No statistically significant difference in the number of patients with SDD post-TAVR among rural compared to urban hospitals (p=0.07). Our findings show the need to advocate for an increase in same-day discharge among patients hospitalized for a transcatheter aortic valve replacement.