Teaima Taha, Carlini Gianfranco Bittar, Gajjar Rohan A, Aziz Imran, Shoura Sami J, Shilbayeh Abdul-Rahim, Battikh Naim, Alyousef Tareq
Division of Cardiology, Department of Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, United States.
World J Cardiol. 2024 Jul 26;16(7):402-411. doi: 10.4330/wjc.v16.i7.402.
Transcatheter aortic valve replacement (TAVR) is a revolutionary procedure for severe aortic stenosis. The coexistence of chronic kidney disease (CKD) and TAVR introduces a challenge that significantly impacts patient outcomes.
To define readmission rates, predictors, and causes after TAVR procedure in CKD stage 1-4 patients.
We used the national readmission database 2018 and 2020 to look into readmission rates, causes and predictors after TAVR procedure in patients with CKD stage 1-4.
Out of 24758 who underwent TAVR and had CKD, 7892 (32.4%) patients were readmitted within 90 days, and had higher adjusted odds of being females (adjusted odds ratio: 1.17, 95%CI: 1.02-1.31, = 0.02) with longer length of hospital stay > 6 days, and more comorbidities including but not limited to diabetes mellitus, anemia, and congestive heart failure (CHF).
Most common causes of readmission included CHF (18.0%), sepsis, and complete atrioventricular block. Controlling readmission predictors with very close follow-up is warranted to prevent such high rate of readmission.
经导管主动脉瓣置换术（TAVR）是治疗严重主动脉瓣狭窄的一项革命性手术。慢性肾脏病（CKD）与TAVR并存带来了一项挑战，对患者预后有显著影响。
确定1-4期CKD患者TAVR术后的再入院率、预测因素及原因。
我们利用2018年和2020年的国家再入院数据库，研究1-4期CKD患者TAVR术后的再入院率、原因及预测因素。
在24758例接受TAVR且患有CKD的患者中，7892例（32.4%）在90天内再次入院，女性再次入院的调整后几率更高（调整优势比：1.17，95%置信区间：1.02-1.31，P = 0.02），住院时间更长>6天，且有更多合并症，包括但不限于糖尿病、贫血和充血性心力衰竭（CHF）。
再入院的最常见原因包括CHF（18.0%）、败血症和完全性房室传导阻滞。有必要通过密切随访控制再入院预测因素，以防止如此高的再入院率。
