Hospital-Based Rehabilitation, Functional Ambulation Status at Discharge, and Hospital Outcomes Across Society of Thoracic Surgeons Risk Groups in Adult Patients After Transcatheter Aortic Valve Replacements.

Introduction Hospital-based rehabilitation after transcatheter aortic valve replacement (TAVR) is novel in the literature. This study aimed to examine clinical outcomes across Society of Thoracic Surgeons (STS) risk scores for patients after TAVR. Methods The study population included 1321 consecutive TAVR recipients. Patients were divided into three groups: low (<4), intermediate (4.0-7.9), and high (>8) STS risk score. Outcomes included receipt of hospital-based physical therapy (PT) or occupational therapy (OT), hospital length of stay (LOS), home vs non-home disposition, and functional ambulation status at discharge.  Results A total of 821 patients (62%) received PT or OT visits; patients in the high and intermediate risk groups had 3.85 and 2.19 times higher odds of receiving PT or OT, respectively. LOS was significantly higher in high and intermediate risk groups (1.99 and 1.48 times longer, respectively; p<0.001). The odds of discharge to home were 61% lower for the intermediate compared to the low group and 79% lower for the high compared to the low group (p<0.001). The odds of being functionally ambulatory at discharge were 50% lower between intermediate and low groups and 70% lower between high and low groups.  Conclusions TAVR recipients who had high STS risk scores were more likely to receive PT or OT and have longer LOS, and less likely to be functionally ambulatory or to return home at discharge. A clinical pathway based on STS risk level could help with patient selection for hospital-based PT or OT.