Hospital readmission rates are similar between patients with mechanical versus bioprosthetic aortic valves.

Abstract

The aim of this study was to evaluate hospital readmission rates and clinical outcomes between bioprosthetic (bAVR) and mechanical (mAVR) aortic valve replacements (AVR). Adults aged 50 years or older undergoing isolated or concomitant AVR between 2011 and 2017 were included. The primary outcome was 5-year hospital readmission. Multivariable logistic regression analysis was used to evaluate the risk-adjusted impact of bAVR versus mAVR on outcomes. A total of 2981 patients were included: 406 (14%) mAVR and 2575 (86%) bAVR. Mean follow-up was 2.9 ± 1.9 years. Operative mortality was comparable (4% bAVR vs 3% mAVR; P = 0.30). There was no risk-adjusted difference in 30-day (hazard ratio [HR] 1.32, P = 0.46), 1-year (HR 1.17, P = 0.52), or 5-year mortality (HR 0.99, P = 0.93). Aortic valve 5-year reoperation rates were comparable (1%, P = 0.32). Risk-adjusted hospital readmissions were similar at 30 days (14% vs 15%; P = 0.63), 1 year (30% vs 27%; P = 0.43), and 5 years (55% vs 53%; P = 0.83) in the bAVR and mAVR groups, respectively. Similar findings were demonstrated when evaluating readmissions for bleeding (5-year readmission: 8% bAVR vs 10% mAVR; P = 0.36). In this analysis of over 2900 AVRs, readmissions within 5 years were comparable between groups at approximately 50%, with patients being at highest risk in the early postdischarge period. Readmissions for bleeding constituted a minority of all readmissions for both cohorts.