Impact of Intensified Outpatient Follow-Up on Rehospitalization After Transcatheter Aortic Valve Implantation: Results From the HOSPITAVI Trial.

Abstract

Patients undergoing transcatheter aortic valve implantation (TAVI) are at increased risk of rehospitalization in the early period after discharge from TAVI. The HOSPITAVI study aimed to compare the impact of a standard versus intensified outpatient follow-up on rehospitalization rates within 90 days after TAVI discharge. Patients were 1:1 randomized to either a standard or intensified outpatient follow-up after TAVI discharge. The primary endpoint was the 90-day hospital rehospitalization rate. In total, 300 patients were included: 150 patients were randomized to standard follow-up and 150 patients to intensified outpatient follow-up. The study population had a median age of 79 years, a median EuroSCORE II of 2.9%, and 72% were discharged the day after TAVI. Within 90 days after discharge, the mean number of all-cause hospital readmissions per patient was 0.44 versus 0.35 (HR 0.8 [95% CI, 0.6-1.2], p = 0.23) in the standard versus intensified group, respectively. The mean number of cardiovascular (CV) readmissions per patient was 0.27 versus 0.15 (HR 0.6 [95% CI, 0.4-1.0], p = 0.04) in the standard versus intensified group, respectively. This resulted in a mean number of CV readmission days per patient of 1.52 days versus 0.49 days within the first 90 days in the standard versus intensified group, respectively (p < 0.05). Following TAVI discharge, there was no significant difference in all-cause rehospitalization rates using a standard versus intensified outpatient follow-up approach. However, an intensified outpatient follow-up reduces the burden of early CV rehospitalization after TAVI discharge. (Rehospitalization after transcatheter aortic valve implantation [HOSPITAVI]; NCT05670041).