Socioeconomic Status Does Not Affect Readmission Risk Following TAVR

Among patients who receive a transcatheter aortic valve replacement (TAVR), socioeconomic status has little impact on 30-day readmission risk. These findings were presented at the Transcatheter Cardiovascular Therapeutics (TCT) Scientific Symposium 2022 from September 17th through 19th, in Boston, Massachusetts.

Investigators from the University of Pittsburgh Medical Center in the United States aimed to evaluate whether household income affected risk for readmission following TAVR. Data for this study were sourced from the Nationwide Readmissions Database collected between 2012 and 2018.

The study population comprised 208,363 individuals. Stratified by household income quartiles, 42,679 were in the lowest 25^th percentile, 56,084 in the 26^th to 50^th percentile, 56,843 in the 51^st to 75^th percentile, and 52,757 in the highest 25^th percentile. Patient cohorts were aged median 81 to 83 years and 45.2% to 47.4% were women. Stratified by household income quartile, the groups differed significantly by age, discharge location, insurance type, and all comorbidities except cerebral vascular disease (all P <.001).

At 30 days, the readmission rate was 17.9% and associated mortality rate was 2.7%.

Risk for 30-day readmission was not associated with the lowest quartile (odds ratio [OR], 1.03; 95% CI, 0.98-1.08; P =.17), the 26^th to 50^th percentile (OR, 1.02; 95% CI, 0.97-1.06; P =.35), or the 51^st to 75^th percentile (OR, 1.01, 95% CI, 0.97-1.05; P =.53) compared with the highest quartile.

Risk for 30-day readmission was associated with discharge to a short-term hospital (OR, 2.1; 95% CI, 1.7-2.5; P <.001); discharge to a skilled nursing facility, intermediate care facility, or other type of facility (OR, 1.7; 95% CI, 1.6-1.8; P <.001); discharge to home health care (OR, 1.4; 95% CI, 1.3-1.4; P <.001); chronic kidney disease (OR, 1.33; 95% CI, 1.29-1.38; P <.001); congestive heart failure (OR, 1.23; 95% CI, 1.01-1.51; P <.001); chronic obstructive pulmonary disease (OR, 1.17; 95% CI, 1.13-1.22; P <.001); diabetes (OR, 1.06; 95% CI, 1.02-1.11; P =.002); or hypertension (OR, 0.87; 95% CI, 0.84-0.91; P =.01).

This study did not find a relationship between socioeconomic status, defined by median household income, and risk for readmission following TAVR. Discharge location and preexisting comorbidities were significant predictors for readmission risk.