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
Stein Ove DanielsenIrene Lie

Abstract

Thirty-day all-cause readmissions are high after aortic valve replacement (AVR). We aimed to assess the effectiveness of a structured telephone follow-up (TFU) and a 24/7 hotline on reducing 30-day all-cause readmission (30-DACR) after AVR, on reducing symptoms of anxiety and depression and on improving perceived health state. A prospective randomized controlled trial was conducted. Patients (n = 288) were randomly allocated to either post-discharge usual care or to care that provided TFU and access to a 24/7 hotline after AVR. Ancillary endpoints were time-to-event (readmission), proportion of avoidable versus unavoidable readmissions after AVR, and predictors of 30-DACR after AVR. 30-DACR was 22.3%. The structured TFU and 24/7 hotline intervention failed to reduce 30-DACR rates after AVR (P = 0.274). Symptoms of anxiety were significantly reduced 30 days after surgery (P = 0.031), an effect that did not persist one year after surgery (P = 0.108). Most readmissions occurred before 15 days post-discharge, and 75% of them were deemed to be unavoidable. Pleural drainage before hospital discharge (P = 0.027) and symptoms of anxiety before surgery (P = 0.003) were predictors of 30-DACR after AVR. The TFU and 24/7 hotline had no eff...Continue Reading

Citations

Mar 5, 2021·Seminars in Thoracic and Cardiovascular Surgery·Linda J Schulte, Hersh S Maniar
Sep 9, 2021·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Alisa N BlumenthalerMara B Antonoff

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