{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T04:16:47Z","timestamp":1775794607016,"version":"3.50.1"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,8,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Nearly 17% of patients are readmitted within 30\u00a0days of discharge after transcatheter aortic valve replacement. Selected patients are discharged to skilled nursing facilities, yet the association between a hospital's practice to discharge home versus to skilled nursing facilities, and readmission remains unclear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The Society of Thoracic Surgeons\/American College of Cardiology Transcatheter Valve Therapy (STS\/ACC TVT) Registry was used to evaluate readmissions among patients undergoing transcatheter aortic valve replacement (2011\u20102015). Hospitals were divided into quartiles (Q1\u2010Q4) based on the percentage of patients discharged directly home. We assessed patient and hospital level characteristics and used hierarchical logistic regression to analyze the association of discharge disposition with 30\u2010day readmission. Our cohort included 18\u00a0568 transcatheter aortic valve replacement patients at 329 US hospitals, of whom 69% were discharged directly home. Hospitals in the highest quartile of direct home discharge (Q4) compared with hospitals in the lowest (Q1) were more likely to use femoral access (75.2% versus 60.1%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), had fewer patients receiving transfusion (26.4% versus 40.9%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and were more likely to be located in the Southern United States (48.8% versus 18.3%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Median 30\u2010day readmission rate was 17.9%. There was no significant difference in 30\u2010day readmissions among quartiles (\n              <jats:italic>P<\/jats:italic>\n              =0.14), even after multivariable adjustment (odds ratio Q4 versus Q1=0.89, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              0.76\u20101.04;\n              <jats:italic>P<\/jats:italic>\n              =0.15). Factors most strongly associated with 30\u2010day readmission were glomerular filtration rate, in\u2010hospital stroke or transient ischemic attack, and nonfemoral access.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">There was no statistically significant association between hospital practice of direct home discharge post\u2013transcatheter aortic valve replacement and 30\u2010day readmission. Further research is needed to understand regional variations and optimum strategies for postdischarge care.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.006127","type":"journal-article","created":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T18:25:38Z","timestamp":1504290338000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Hospital Practice of Direct\u2010Home Discharge and 30\u2010Day Readmission After Transcatheter Aortic Valve Replacement in the Society of Thoracic Surgeons\/American College of Cardiology Transcatheter Valve Therapy (STS\/ACC TVT) Registry"],"prefix":"10.1161","volume":"6","author":[{"given":"John A.","family":"Dodson","sequence":"first","affiliation":[{"name":"Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY"},{"name":"Division of Healthcare Delivery Science, Department of Population Health, New York University School of Medicine, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathew R.","family":"Williams","sequence":"additional","affiliation":[{"name":"Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY"},{"name":"Department of Cardiac Surgery, New York University School of Medicine, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"},{"name":"University of Missouri\u2010Kansas City School of Medicine, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pratik","family":"Manandhar","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sreekanth","family":"Vemulapalli","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Blaum","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Medicine, New York University School of Medicine, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua","family":"Zhong","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John S.","family":"Rumsfeld","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Aurora, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith S.","family":"Hochman","sequence":"additional","affiliation":[{"name":"Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.1474"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1212324"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00059-5"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2011.06.011"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2006.04.015"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182092c27"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-199507000-00006"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.110.959171"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.282043"},{"key":"e_1_3_4_11_2","unstructured":"American College of Cardiology; Society of Thoracic Surgeons . ACC\/STS TVT Registry: data collection. Available at: https:\/\/www.ncdr.com\/webncdr\/tvt\/home\/data-collection. Accessed December 15 2016."},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.216476"},{"key":"e_1_3_4_13_2","unstructured":"Readmissions reduction program (HRPP): Department of Health and Human Services Centers for Medicare & Medicaid Services. Available at: https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/AcuteInpatientPPS\/Readmissions-Reduction-Program.html. Accessed December 15 2016."},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.11.033"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.282437"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1303118"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2011.01773.x"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2009.199"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.116.002756"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1515"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1302981"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.117.006127","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:53:48Z","timestamp":1715597628000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.117.006127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,2]]},"references-count":20,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017,8,2]]}},"alternative-id":["10.1161\/JAHA.117.006127"],"URL":"https:\/\/doi.org\/10.1161\/jaha.117.006127","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,2]]},"assertion":[{"value":"2017-03-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-08-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e006127"}}