Incidence, Predictors, and Prognostic Impact of Rehospitalization after Transcatheter Aortic Valve Implantation

The incidence, predictors, and prognostic impact of rehospitalization following transcatheter aortic valve implantation (TAVI) has not been widely investigated and reported. This information is especially missing based on real-world practice data. Hence, the authors retrospectively analyzed a total of 1,397 patients who underwent TAVI between 2016 and 2020 in East Denmark. The medical records of all patients were reviewed to validate rehospitalizations up to one year after discharge from the index TAVI. A total of 615 patients (44 percent) had an unplanned rehospitalization within the first year after TAVI. The incidence of unplanned rehospitalization rate was three times higher in the early post-TAVI period (i.e., within 30 days) compared with the late post-TAVI period (i.e., 30 days to 1 year; 2.5 vs. 0.8 per patient-year, respectively; P < 0.001). Early rehospitalization was most frequently procedure related, whereas late rehospitalization was mostly related to baseline comorbidities. Early and late heart failure related rehospitalization was associated with a considerably higher one and five-year mortality risk (hazard ratio (HR) of 4.3 and 3.2 for 1-year mortality and HR of 3.2 and 2.9 for 5-year mortality, respectively; P < 0.001). Given the elevated frequency of rehospitalization following TAVI and the poor long-term survival associated with heart failure related rehospitalization, the authors conclude that TAVI trials should include rehospitalization as a major study endpoint.