Predictors of Hospital Readmission after Trans-Catheter Aortic Valve Implantation in Ontario
Bibliographic record
Abstract
Trans-catheter aortic valve implantation (TAVI) is the standard of care for treatment of aortic stenosis in patients deemed too high risk for surgical valve replacement. However, recent data have shown that patients who undergo TAVI have exceedingly high rates of hospital readmission. Our objectives were to determine the predictors of readmission while seeking to identify any modifiable factors. We conducted a retrospective observational cohort study based on abstraction of detailed clinical data that included 937 patients discharged alive after TAVI. Readmission occurred in 17% of patients within 30 days and 49% within 1 year. Heart failure was the most common cause of readmission. Bleeding was also a major cause of readmission and many covariates related to bleeding were associated with a higher hazard of readmission. Transition of care factors were not associated with reduced readmission. These results suggest that quality improvement efforts directed at optimal heart failure management and bleeding avoidance, may reduce readmission.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".