The implementation of a streamlined TAVI patient pathway across five European countries: BENCHMARK registry.

Background: Benchmark best practices have been shown to streamline the clinical pathway for patients undergoing transcatheter aortic valve implantation (TAVI), but the impact in diverse health systems is unknown. Aims: We evaluated the impact of Benchmark best practices implementation in Germany, Au...

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Detalles Bibliográficos
Autores: Saia, Francesco., Lauck, Sandra, Durand, Eric, Muir, Douglas F, Spence, Mark, Vasa-Nicotera, Mariuca, Wood, David, Urbano-Carrillo, Cristóbal A, Bouchayer, Damien, Iliescu, Vlad Anton, Etienne, Christophe Saint, Leclercq, Florence, Auffret, Vincent, Asmarats, Lluis, Di Mario, Carlo, Veugeois, Aurelie, Maly, Jiri, Schober, Andreas, Nombela-Franco, Luis, Werner, Nikos, Gómez-Hospital, Joan Antoni, Mascherbauer, Julia, Musumeci, Giuseppe, Meneveau, Nicolas, Meurice, Thibaud, Mahfoud, Felix, De Marco, Federico, Seidler, Tim, Leuschner, Florian, Joly, Patrick, Collet, Jean-Philippe, Vogt, Ferdinand, Di Lorenzo, Emilio, Kuhn, Elmar, McCalmont, Gemma, Rakova, Radka, Wesselink, Wilbert, Kurucova, Jana, Hachaturyan, Violetta, Lüske, Claudia M, Bramlage, Peter, Frank, Derk
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/24965
Acceso en línea:https://hdl.handle.net/20.500.13003/24965
Access Level:acceso abierto
Palabra clave:Aortic Valve Stenosis
Quality of Health Care
Transcatheter Aortic Valve Replacement
Estenosis de la Válvula Aórtica
Calidad de la Atención de Salud
Reemplazo de la Válvula Aórtica Transcatéter
Aortic stenosis
Clinical care
Prospective registry
Quality of care
TAVI
Transcatheter aortic valve implantation
Descripción
Sumario:Background: Benchmark best practices have been shown to streamline the clinical pathway for patients undergoing transcatheter aortic valve implantation (TAVI), but the impact in diverse health systems is unknown. Aims: We evaluated the impact of Benchmark best practices implementation in Germany, Austria, France, Spain, and Italy. Methods: International, multicentre registry of severe symptomatic aortic stenosis (AS) patients undergoing TAVI with a balloon-expandable valve, before and after Benchmark best practices implementation. Objectives were to reduce overall and intensive care unit (ICU) length of stay (LoS), and to document 30-day safety. Results: A total of 890 patients were analysed in France, 454 in Spain, 362 in Germany, 300 in Italy, and 176 in Austria. Patients had the highest surgical risk in Germany (EuroSCORE II 6.8 ± 7.3%) and lowest in Spain (3.8 ± 2.6%). Austrian patients reported higher rates of prior myocardial infarction, severe pulmonary hypertension, and aortic valve-related symptoms at baseline. After the implementation of Benchmark best practices, the median hospital LoS was significantly reduced in France (5 vs. 3 days, p < 0.001), Spain (6 vs. 4, p < 0.001), Germany (9 vs. 6, p < 0.001), and Italy (7 vs. 5, p < 0.001); reductions in median ICU LoS were reported in France (1.1 vs. 0 days, p < 0.001), Spain (1.9 vs. 1, p < 0.001), and Germany (1 vs. 0.9, p = 0.004). Across all countries, 30-day safety outcomes were uncompromised and reduced rates of major vascular complications rates were observed in Germany (5.9 vs. 0.0%, p < 0.001). Conclusion: The implementation of Benchmark best practices in diverse European healthcare systems resulted in reduced hospital and ICU LoS without compromising patient safety. Trial registration: ClinicalTrials.gov NCT04579445, September 28th, 2020.

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