Acute Care Physical and Occupational Therapy Early Intervention Pathway After Transcatheter Aortic Valve Replacement: A Retrospective Study

Authors

Adele Myszenski, Henry Ford HealthFollow
Barbara Michon, Henry Ford HealthFollow
Danielle Lupcke, Henry Ford HealthFollow
Cynthia Melican, Henry Ford HealthFollow
Narmean Pedawi, Henry Ford Health
Nazir Ahmed, Henry Ford HealthFollow
Janet F. Wyman, Henry Ford HealthFollow

Recommended Citation

Myszenski A, Michon B, Lupcke D, Melican C, Pedawi N, Ahmed N, Wyman JF. Acute Care Physical and Occupational Therapy Early Intervention Pathway After Transcatheter Aortic Valve Replacement: A Retrospective Study. Journal of Acute Care Physical Therapy 2021; 12(2):65-71.

Document Type

Article

Publication Date

4-1-2021

Publication Title

Journal of Acute Care Physical Therapy

Abstract

Purpose: Transcatheter aortic valve replacement (tAVR) has emerged as a less-invasive alternative to traditional surgical aortic valve replacement. The purpose of this study was to examine the effect of a novel clinical pathway with an emphasis on early physical therapy and occupational therapy on patients undergoing tAVR in the acute care setting.

Methods: A retrospective study was conducted involving 189 patients who underwent tAVR. The control group (n = 74) included patients who underwent tAVR prior to the implementation of the pathway. The intervention group (n = 115) included patients who underwent tAVR following the implementation of the pathway. Inpatient length of stay and discharge disposition were measured.

Results: No differences in demographics or clinical variables were found; for example, mean age was 79.5 ± 11.2 years, with 57% male in the control group versus 81.6 ± 8.4 years and 59% male in the intervention group. Length of stay was significantly lower in the intervention group (control 6.9 ± 5.4 days, intervention 4.8 ± 5.4 days,P = .009) and significantly shorter length of stay postprocedure (control 4.8 ± 2.9 days, intervention 3.5 ± 4.0, P= .015). The incidence of the patient's discharge disposition to home increased from 77% of patients in the control group to 86% of patients in the intervention group but was not statistically significant (P = .118).

Conclusions: A clinical pathway specific to patients post-tAVR provided early mobility, targeted education, individualized functional goals, and discharge disposition recommendations. Patients in the intervention group experienced reduced hospital length of stay.

Comments

doi: 10.1097/JAT.0000000000000147

PubMed ID

Not assigned.

Volume

12

Issue

2

First Page

65

Last Page

71