Next-Day Discharge vs Early Discharge After Transcatheter Aortic Valve Replacement: Systematic Review and Meta-Analysis
Document Type
Article
Publication Date
9-24-2021
Publication Title
Current problems in cardiology
E-ISSN
1535-6280
Department(s)
Cardiology Division; Fellows and Residents
Abstract
With the growing utilization of transcatheter aortic valve replacement (TAVR) as an alternative option to surgical valve replacement (SAVR) in patients considered to be suboptimal for surgery, there is a need to explore the possibility of next day discharge (NDD) and its potential outcomes. The aim of our study is to compare outcomes and complications following NDD vs the standard early discharge (ED) (less than 3 days). A comprehensive literature search was performed in PubMed, Embase, and Cochrane to identify relevant trials. Summary effects were calculated using a DerSimonian and Laird random effects model as odds ratio with 95% confidence intervals for all the clinical endpoints. Studies comparing same-day or next-day discharge vs discharge within the next three days were included in our analysis. 6 studies with 2,672 patients were identified. The risk of bleeding and vascular complications was significantly lower in patients with NDD compared to ED (OR 0.10, P < 0.00001 and OR 0.22, P = 0.002 respectively). The incidence of permanent pacemaker (PPM) implants was significantly lower in patients who had NDD compared to ED (OR 0.21, P = 0.0005). The incidence of 30 day mortality, stroke, AKI and readmission rates was not different between the two groups. NDD after TAVR allows for reduction in hospital stay and can mitigate hospital costs without an increased risk of complications. Our analysis shows that complication rate is comparable to ED, NDD is a reasonable option for certain patients with severe aortic stenosis who undergo TAVR. Further studies are needed to elucidate whether higher risk patients who would benefit from an extended inpatient monitoring post TAVR.
First Page
100998
DOI
10.1016/j.cpcardiol.2021.100998
PubMed ID
34571105
Recommended Citation
Gupta, R., Mahajan, S., Mehta, A., Nyaeme, M., Mehta, N. A., Cheema, A., Khanal, L., Malik, A. H., Aronow, W. S., Vyas, A., Mehta, S. S., & Patel, N. C. (2021). Next-Day Discharge vs Early Discharge After Transcatheter Aortic Valve Replacement: Systematic Review and Meta-Analysis. LVHN Scholarly Works. Retrieved from https://scholarlyworks.lvhn.org/research-historical-works/34
DOI: 10.1016/j.cpcardiol.2021.100998