Aortic valve replacement surgery is now safer and the recovery has become easier, as fewer patients undergoing AVR surgery are being re-hospitalized, reveals a study. The article is published in the February 2015 issue of The Annals of Thoracic Surgery.
Among the 293,853 patients in the study group, three in five were free from hospitalization during the year following surgery, and 1-year hospitalization rates declined from 44.2% in 1999 to 40.9% in 2010. Roughly half of all hospitalizations occurred during the first 30 days after surgery, which indicates the need to monitor patients closely during this period of heightened risk. Average cumulative length of stay also decreased, from 4.8 days to 4.0 days.
Based on their findings, the researchers concluded that both the rates of hospitalization and the average total number of days spent in the hospital in the year following surgery have decreased throughout the last decade (1999 to 2010); however, certain subgroups (older patients, females, black patients, and those undergoing combined AVR and coronary artery bypass grafting surgery) had higher rates of hospitalization, which the researchers noted warrants increased attention.
Importance of Reducing Hospital Readmission
In an invited commentary in the same issue of The Annals, Edward B. Savage, MD, from Cleveland Clinic Florida in Weston, noted the importance of reducing hospital readmission rates. While the causes of readmission in this study were multiple, the three most common were heart failure, arrhythmia [irregular heartbeat], and postoperative complications, all directly attributable to the primary operation.
The next challenge is to anticipate these problems and reduce readmission rates and the associated costs. Hopefully the authors in future work can identify practice patterns that will successfully reduce readmissions.