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Revista argentina de cardiología
versión On-line ISSN 1850-3748
Resumen
GARMENDIA, CRISTIAN M. et al. Prevalence, Predictors and Clinical Impact of Readmission in Patients with Aortic Stenosis Evaluated by a Heart Team. Rev. argent. cardiol. [online]. 2021, vol.89, n.6, pp.501-506. Epub 01-Dic-2021. ISSN 1850-3748.
Background:
There is scarce evidence in our setting regarding the prevalence of readmission, risk factors and clinical evolution of patients with severe aortic stenosis (AS) evaluated by a Heart Team.
Objective:
The aim of this study was to assess the prevalence, predictors and clinical evolution of readmission in patients with severe AS evaluated by a Heart Team.
Methods:
This was an observational, single-center, retrospective cohort study including patients with severe AS evaluated by a Heart Team. Total cohort characteristics were analyzed at baseline, and after stratification according to the presence or absence of readmission during a 2-year follow-up period.
Results:
Mean population age (n = 275) was 83.3 ± 6.9 years, and 51.1% were female patients. The prevalence of readmissions was 21.5%. Readmitted patients were older (85.54 ± 6.66 vs. 82.62 ± 6.87 years; p = 0.003) and had greater frailty (97,4% vs. 89.3%; p = 0.035), surgical risk (STS 6.11 ± 4.79 vs. 4.72 ± 4.12; p = 0.033), and previous history of atrial fibrillation (AF) (40.7% vs. 23.6%; p = 0.009), compared with non-readmitted patients. Prior AF was an independent risk factor of readmission (OR 4.59 [IC95% 1.95-10.81]; p <0.001). The prevalence of readmission was 33.9% for percutaneous aortic valve implantation (TAVI), 1.7% for valve replacement surgery (AVRS), and 64.4% for conservative treatment (p = 0.002). At 2 years, readmission was associated with lower survival (47.5% vs. 13.4%; p <0.001).
Conclusions:
In patients with severe AS evaluated by a Heart Team, a significant prevalence of readmission was observed at 2 years, and this was associated with higher mortality. Atrial fibrillation was an independent risk factor of readmissions.
Palabras clave : Aortic stenosis; Readmission; Mortality.