Risk scoring model for prediction of non-home discharge after transcatheter aortic valve replacement  

作　　者：Alexis K Okoh Ebru Ozturk Justin Gold Emaad Siddiqui Nehal Dhaduk Bruce Haik Chun-Guang CHEN Marc Cohen Mark J Russo 

机构地区：[1]Cardiovascular Outcomes Research Institute,RWJ Barnabas Health-NBIMC,Newark,New Jersey,USA [2]Department of Medicine,Division of Biostatistics,Hacettepe University,Ankara,Turkey [3]Rutgers New Jersey Medical School,Newark,New Jersey,USA [4]Department of Surgery,Division of Cardiothoracic Surgery,Rutgers Robert Wood Johnson Medical School,New Brunswick,New Jersey,USA

出　　处：《Journal of Geriatric Cardiology》2020年第10期621-627,共7页老年心脏病学杂志（英文版）

摘　　要：Background Patients undergoing transcatheter aortic valve replacement(TAVR) are likely to be discharged to a location other than home. We aimed to determine the association between preoperative risk factors and non-home discharge after TAVR. Methods Patients discharged alive after TAVR at three centers were identified from a prospectively maintained database randomly divided into 80% derivation and 20% validation cohorts. Logistic regression models were fit to identify preoperative factors associated with non-home discharge in the derivation cohort. Multivariable models were developed and a nomogram based risk-scoring system was developed for use in preoperative counseling. Results Between June 2012 and December 2018, a total of 1,163 patients had TAVR at three centers. Thirty-seven patients who died before discharge were excluded. Of the remaining 1,126 patients(97%) who were discharged alive, the incidence of non-home discharge was 25.6%(n = 289). The patient population was randomly divided into the 80%(n = 900) derivation cohort and 20%(n = 226) validation cohort. Mean ± SD age of the study population was 83 ± 8 years. In multivariable analysis, factors that were significantly associated with non-home discharge were extreme age, female sex, higher STS scores, use of general anesthesia, elective procedures, chronic liver disease, non-transfemoral approach and postoperative complications. The unbiased estimate of the C-index was 0.81 and the model had excellent calibration. Conclusions One out of every four patients undergoing TAVR is discharged to a location other than home. Identification of preoperative factors associated with non-home discharge can assist patient counseling and postoperative disposition planning.

关 键 词：Aortic valve replacement Non-home discharge Postoperative risk TRANSCATHETER TRANSFEMORAL 

分 类 号：R654.2[医药卫生—外科学]