Background. Readmission rates are well established as a quality indicator for heart failure (HF). We analyzed HF readmission rates after mitral valve repair (MVP) and replacement (MVR). Methods. We included 21,138 Medicare beneficiaries with primary isolated MVP (n = 6,896) or MVR (n = 14,242) from 2000 through 2004. Readmission rates were identified using MedPar records subsequent to the index procedure during a 5-year follow-up. Treating death as a competing risk, cumulative readmission incidences were analyzed and stratified by presence or absence of preoperative HF. Results. Preoperative HF was present in 61.0% of the patients. All-cause readmission rates were 24.9% at 30 days and 78.0% at 5 years. The cumulative incidence of readmission for HF remained almost 3 times higher in patients with preoperative HF compared with those without for MVP (2.1% vs 5.9% in 30 days and 10.3% vs 26.3% in 5 years) and 2 times higher for MVR (3.6% vs 7.4% in 30 days and 15.8% vs 30.4% in 5 years). Regardless of procedure type, patients without preoperative HF had significantly lower HF readmission rates (3.0% vs 7.0% in the first 30 days and 13.6% vs 29.2% after 5 years) (p = 0.0001). Conclusions. Hospital readmission after mitral surgery is high. Preoperative heart failure is associated with higher postoperative readmission rates. Because admission for heart failure accounts for a significant proportion of these readmissions, close follow-up of patients with known mitral valve disease and referral to surgery prior to development of heart failure may decrease postoperative readmission rates. (C) 2014 by The Society of Thoracic Surgeons
机构:
Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USAUniv Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Badhwar, Vinay
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Peterson, Eric D.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Peterson, Eric D.
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Jacobs, Jeffrey P.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Jacobs, Jeffrey P.
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He, Xia
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
He, Xia
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Brennan, J. Matthew
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Brennan, J. Matthew
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O'Brien, Sean M.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
O'Brien, Sean M.
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Dokholyan, Rachel S.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Dokholyan, Rachel S.
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George, Kristopher M.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
George, Kristopher M.
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Bolling, Steven F.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Bolling, Steven F.
;
Shahian, David M.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Shahian, David M.
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Grover, Fredrick L.
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Grover, Fredrick L.
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Edwards, Fred H.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Edwards, Fred H.
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Gammie, James S.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
机构:
Univ Michigan, Dept Surg, Michigan Surg Collaborat Outcomes Res & Evaluat, Ann Arbor, MI 48109 USAUniv Michigan, Dept Surg, Michigan Surg Collaborat Outcomes Res & Evaluat, Ann Arbor, MI 48109 USA
Dimick, Justin B.
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Birkmeyer, John D.
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Univ Michigan, Dept Surg, Michigan Surg Collaborat Outcomes Res & Evaluat, Ann Arbor, MI 48109 USAUniv Michigan, Dept Surg, Michigan Surg Collaborat Outcomes Res & Evaluat, Ann Arbor, MI 48109 USA
机构:
Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USAUniv Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Badhwar, Vinay
;
Peterson, Eric D.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Peterson, Eric D.
;
Jacobs, Jeffrey P.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Jacobs, Jeffrey P.
;
He, Xia
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
He, Xia
;
Brennan, J. Matthew
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Brennan, J. Matthew
;
O'Brien, Sean M.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
O'Brien, Sean M.
;
Dokholyan, Rachel S.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Dokholyan, Rachel S.
;
George, Kristopher M.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
George, Kristopher M.
;
Bolling, Steven F.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Bolling, Steven F.
;
Shahian, David M.
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h-index: 0
机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Shahian, David M.
;
Grover, Fredrick L.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Grover, Fredrick L.
;
Edwards, Fred H.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
Edwards, Fred H.
;
Gammie, James S.
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机构:Univ Pittsburgh, Med Ctr, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
机构:
Univ Michigan, Dept Surg, Michigan Surg Collaborat Outcomes Res & Evaluat, Ann Arbor, MI 48109 USAUniv Michigan, Dept Surg, Michigan Surg Collaborat Outcomes Res & Evaluat, Ann Arbor, MI 48109 USA
Dimick, Justin B.
;
Birkmeyer, John D.
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Univ Michigan, Dept Surg, Michigan Surg Collaborat Outcomes Res & Evaluat, Ann Arbor, MI 48109 USAUniv Michigan, Dept Surg, Michigan Surg Collaborat Outcomes Res & Evaluat, Ann Arbor, MI 48109 USA