Table 1.
Characteristics Across Quartiles of Direct Discharge Home Post‐TAVR
| Direct Discharge Home % (Number of Hospitals) [Number of Patents] | Overall (N=329) [18 568] | Quartile 1 9.3% to 59.2% (N=82) [4473] | Quartile 2 59.3% to 72.1% (N=81) [5435] | Quartile 3 72.2% to 81.6% (N=84) [5011] | Quartile 4 81.7% to 100.0% (N=82) [3649] | P Valuea |
|---|---|---|---|---|---|---|
| Patient characteristics | ||||||
| Age (median, IQR) | 84.0, 79.0 to 88.0 | 84.0, 79.0 to 88.0 | 84.0, 79.0 to 88.0 | 84.0, 78.0 to 88.0 | 83.0, 78.0 to 87.0 | <0.001 |
| Female sex, N (%) | 9028 (48.6) | 2317 (51.8) | 2655 (48.9) | 2429 (48.5) | 1627 (44.6) | <0.001 |
| Nonwhite race, N (%) | 865 (4.7) | 158 (3.5) | 239 (4.4) | 211 (4.2) | 257 (7.0) | <0.001 |
| Coronary disease, N (%) | 10 684 (57.5) | 2536 (56.7) | 3112 (57.3) | 2958 (59.0) | 2078 (57.0) | 0.129 |
| Atrial fibrillation, N (%) | 7762 (41.8) | 1974 (44.1) | 2298 (42.3) | 2121 (42.3) | 1369 (37.5) | <0.001 |
| Prior stroke, N (%) | 2223 (12.0) | 578 (12.9) | 629 (11.6) | 630 (12.6) | 386 (10.6) | 0.008 |
| Diabetes mellitus, N (%) | 6547 (35.3) | 1498 (33.5) | 1922 (35.4) | 1824 (36.4) | 1303 (35.7) | 0.017 |
| Peripheral arterial disease, N (%) | 5672 (30.6) | 1369 (30.6) | 1718 (31.6) | 1533 (30.6) | 1052 (28.8) | 0.094 |
| Heart failure, N (%) | 14 244 (76.7) | 3500 (78.3) | 4250 (78.2) | 3732 (74.5) | 2762 (75.7) | <0.001 |
| Chronic lung disease, N (%) | 5050 (27.2) | 1125 (25.2) | 1545 (28.4) | 1396 (27.9) | 984 (27.0) | 0.001 |
| Home oxygen, N (%) | 2365 (12.7) | 546 (12.2) | 673 (12.4) | 697 (13.9) | 449 (12.3) | 0.045 |
| Renal function, N (%) | 0.150 | |||||
| GFR ≥30 | 16 837 (90.7) | 4017 (89.8) | 4933 (90.8) | 4557 (90.9) | 3330 (91.3) | |
| GFR <30 | 996 (5.4) | 248 (5.5) | 311 (5.7) | 264 (5.3) | 173 (4.7) | |
| On dialysis | 689 (3.7) | 187 (4.2) | 185 (3.4) | 177 (3.5) | 140 (3.8) | |
| STS predicted mortality rate (median, IQR) | 6.8%, 4.5% to 10.2% | 6.9%, 4.7% to 10.3% | 7.0%, 4.7% to 10.6% | 6.8%, 4.5% to 10.3% | 6.3%, 4.2% to 9.4% | <0.001 |
| Treatment characteristics | ||||||
| LVEF (median, IQR) | 57%, 45% to 63% | 56%, 45% to 63% | 58%, 45% to 65% | 58%, 45% to 63% | 56%, 48% to 63% | 0.011 |
| Femoral access, N (%) | 12 473 (67.2) | 2688 (60.1) | 3468 (67.1) | 3393 (67.7) | 2744 (75.2) | <0.001 |
| General anesthesia, N (%) | 17 461 (95.0) | 4385 (98.0) | 5104 (93.9) | 4728 (94.4) | 3424 (93.8) | <0.001 |
| Transfusion, N (%) | 6300 (33.9) | 1829 (40.9) | 1941 (35.7) | 1568 (31.3) | 962 (26.4) | <0.001 |
| Vascular access complication, N (%) | 953 (8.0) | 220 (7.8) | 279 (7.8) | 240 (7.8) | 214 (8.8) | 0.491 |
| In‐hospital stroke/TIA, N (%) | 347 (1.9) | 81 (1.8) | 124 (2.3) | 89 (1.8) | 53 (1.5) | 0.037 |
| Cardiac arrest, N (%) | 396 (2.1) | 89 (2.0) | 135 (2.5) | 117 (2.3) | 55 (1.5) | 0.012 |
| Aortic dissection, N (%) | 38 (0.2) | 10 (0.2) | 12 (0.2) | 8 (0.2) | 8 (0.2) | 0.873 |
| Hours in ICU (median, IQR) | 37.0, 24.0 to 70.9 | 47.7, 25.0 to 76.0 | 40.7, 24.2 to 72.0 | 40.0, 24.2 to 70.5 | 28.0, 23.3 to 49.9 | <0.001 |
| Hospital characteristics | ||||||
| Region, N (%) | <0.001 | |||||
| Northeast | 76 (23.1) | 33 (40.2) | 26 (32.1) | 13 (15.5) | 4 (4.9) | |
| West | 58 (17.6) | 9 (11.0) | 12 (14.8) | 15 (17.9) | 22 (26.8) | |
| Midwest | 78 (23.7) | 25 (30.5) | 16 (19.8) | 21 (25.0) | 16 (19.5) | |
| South | 117 (35.6) | 15 (18.3) | 27 (33.3) | 35 (41.7) | 40 (48.8) | |
| Annual TAVR volume (median, IQR) | 21.0, 14.0 to 30.0 | 20.0, 13.0 to 25.0 | 24.0, 16.0 to 35.0 | 22.0, 15.0 to 32.5 | 19.0, 13.0 to 29.0 | 0.052 |
| Number of beds (median, IQR) | 533.0, 383.0 to 695.0 | 542.5, 352.0 to 687.0 | 571.0, 409.0 to 729.0 | 526.5, 393.5 to 664.5 | 496.0, 371.0 to 700.0 | 0.518 |
| Teaching hospital, N (%) | 207 (62.9) | 51 (62.2) | 54 (66.7) | 58 (69.1) | 44 (53.7) | 0.183 |
GFR indicates glomerular filtration rate; ICU, intensive care unit, IQR, interquartile range; LVEF, left ventricular ejection fraction; STS, Society of Thoracic Surgeons; TAVR, transcatheter aortic valve replacement; TIA, transient ischemic attack.
a
P value for comparison across hospital quartiles.