Stein Ove Danielsen has tested a telephone-based follow-up intervention to see if it reduces the high short-term readmission rates following aortic valve replacement.
MAIN RESULTS:
- 30-day readmissions following aortic valve replacement is high.
- A telephone-based follow-up does not reduce 30-day readmission after aortic valve implantation.
- Anixiety symptoms are reduced with structured telephone follow-up after aortic valve replacement.
THESIS DEFENCE:
Thesis: Optimising patient discharge and follow-up after surgical aortic valve replacement to reduce readmissions and improve patient-reported outcomes
Candidate: Stein Ove Danielsen
Time: June 18, 2020 at 10:15
Place: Online-based solution, due to the covid-19 situation
Link to university website
SUMMARY:
(1) A meta-analysis performed by Danielsen and colleagues shows that 17% are readmitted to hospital within 30 days of aortic valve surgery. Following TAVI the readmission rate is 16%. The review includes results from 32 articles with a total of more than 500,000 patients.
The most frequent causes of rehospitalization are heart failure, arrhythmia, infection and respiratory problems. No risk factors for readmission following surgery were found, whereas patients with diabetes, chronic lung disease, atrial fibrillation and kidney problems are at increased risk of readmission following TAVI.
(2) Structured telephone follow-up and a 24/7 hotline did not reduce 30-day all-cause readmissions following aortic surgery. 288 patients were included in the randomized controlled trial that compared the telephone-based follow-up intervention with usual care.
22.3% of the patients were readmitted during follow-up, and patients with anxiety symptoms and pleural drainage before discharge were at increased risk. The intervention reduced symptoms of anxiety, but depression and participant-reported health state were unaffected.
(3) More than half of the patients in the randomized controlled study reported to be satisfied with the telephone intervention and almost everyone felt safe.
REFERENCES:
(1) Danielsen, S. O., Moons, P., Sandven, I., Leegaard, M., Solheim, S., Tønnessen, T., & Lie, I. (2018). Thirty-day readmissions in surgical and transcatheter aortic valve replacement: a systematic review and meta-analysis. International journal of cardiology, 268, 85-91.
(2) Danielsen, S. O., Moons, P., Sandvik, L., Leegaard, M., Solheim, S., Tønnessen, T., & Lie, I. (2020). Impact of telephone follow-up and 24/7 hotline on 30-day readmission rates following aortic valve replacement-a randomized controlled trial. International Journal of Cardiology, 300, 66-72.
(3) Danielsen, S. O., Moons, P., Leegaard, M., Solheim, S., Tønnessen, T., & Lie, I. (2020). Facilitators of and barriers to reducing thirty-day readmissions and improving patient-reported outcomes after surgical aortic valve replacement: a process evaluation of the AVRre trial. BMC health services research, 20, 1-11.
