Since the first implantation of a percutaneous aortic bioprosthesis (TAVI) in 2002 (Cribier et al. Circulation 2002), TAVI occupies an increasing place in the management of aortic stenosis (AR) . Initially reserved for inoperable patients at high surgical risk, TAVI is also recommended in patients at intermediate risk, especially when a femoral approach (TF) is possible (Baumgartner et al. Eur Heart J. 2017). Currently, there is no recommendation regarding length of stay after TAVI and practices are extremely heterogeneous. Despite the growing experience of centers, better patient selection and a reduction in complications, the length of stay after TAVI remains very high in France. Faced with the great disparity observed between the centers, efforts are necessary to educate the centers in order to further reduce the length of stay after TF-TAVI. The aim of the study is to evaluate the effectiveness of an intervention based on training teams to reduce the length of stay after TF-TAVI.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
1,842
Training dedicated on implementation of "organizational" and "therapeutic" measures (for prevention and management of complications) to reduce lenght-of-stay after TF TAVI.
CHU d'Amiens
Amiens, France
CHU d'Angers
Angers, France
CHU de Bordeaux
Bordeaux, France
CHU de Brest
Brest, France
CHU de Caen
Caen, France
Hôpital privé Saint Martin
Caen, France
CHU de Clermont-Ferrand
Clermont-Ferrand, France
Hôpital Henri Mondor (AP-HP)
Créteil, France
CHU de Dijon
Dijon, France
CHU de Grenoble
Grenoble, France
...and 10 more locations
To evaluate the effectiveness of a multi-component organizational intervention
Proportion of patients benefiting from TF-TAVI with a length of stay less than or equal to 3 days.
Time frame: Year 1
To evaluate the safety of the intervention
This outcome will be evaluated using : * the average length of stay, * the 30-day rehospitalization rate and * the 30-day death rate.
Time frame: Day 30
To evaluate the budgetary impact of the intervention
This outcome will be assessed using: * the hospital costs from the point of view of the hospital and * the financial gains for health insurance that would be associated with the generalization of the intervention in France.
Time frame: Year 1
To evaluate the implementation of the intervention
This outcome will be evaluated using the rate of adherence of the centers to the procedures aiming to reduce the length of stay (questionnaires)
Time frame: Year 1
To identify the factors associated with the effectiveness and safety of the intervention
This outcome will be assessed using factors associated with lengths of stay less than or equal to 3 days.
Time frame: Year 1
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