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Background <p>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.</p> Aims <p>We evaluated the impact of Benchmark best practices implementation in Germany, Austria, France, Spain, and Italy.</p> Methods <p>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.</p> Results <p>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, <i>p</i> &lt; 0.001), Spain (6 vs. 4, <i>p</i> &lt; 0.001), Germany (9 vs. 6, <i>p</i> &lt; 0.001), and Italy (7 vs. 5, <i>p</i> &lt; 0.001); reductions in median ICU LoS were reported in France (1.1 vs. 0 days, <i>p</i> &lt; 0.001), Spain (1.9 vs. 1, <i>p</i> &lt; 0.001), and Germany (1 vs. 0.9, <i>p</i> = 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%, <i>p</i> &lt; 0.001).</p> Conclusion <p>The implementation of Benchmark best practices in diverse European healthcare systems resulted in reduced hospital and ICU LoS without compromising patient safety.</p> Trial registration <p>ClinicalTrials.gov NCT04579445, September 28th, 2020</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月22日

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  • Francesco Saia,
  • Sandra Lauck,
  • Eric Durand,
  • Douglas F. Muir,
  • Mark Spence,
  • Mariuca Vasa-Nicotera,
  • David Wood,
  • Cristóbal A. Urbano-Carrillo,
  • Damien Bouchayer,
  • Vlad Anton Iliescu,
  • Christophe Saint Etienne,
  • Florence Leclercq,
  • Vincent Auffret,
  • Lluis Asmarats,
  • Carlo Di Mario,
  • Aurelie Veugeois,
  • Jiri Maly,
  • Andreas Schober,
  • Luis Nombela-Franco,
  • Nikos Werner,
  • Joan Antoni Gómez-Hospital,
  • Julia Mascherbauer,
  • Giuseppe Musumeci,
  • Nicolas Meneveau,
  • Thibaud Meurice,
  • Felix Mahfoud,
  • Federico De Marco,
  • Tim Seidler,
  • Florian Leuschner,
  • Patrick Joly,
  • Jean Philippe Collet,
  • Ferdinand Vogt,
  • Emilio Di Lorenzo,
  • Elmar Kuhn,
  • Vicente Peral Disdier,
  • Gemma McCalmont,
  • Radka Rakova,
  • Wilbert Wesselink,
  • Jana Kurucova,
  • Violetta Hachaturyan,
  • Claudia M. Lüske,
  • Peter Bramlage,
  • Derk Frank

摘要

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