Outcomes and predictors of readmission after implantation of a percutaneous left atrial appendage occlusion device in the United States: A propensity score‐matched analysis from The National Readmission Database

Background Left atrial appendage occlusion (LAAO) devices have become a favorable alternative option among nonvalvular atrial fibrillation (AF) patients with long‐term contraindication to anticoagulation. Real‐world experience with postprocedural readmission rates and predictors of readmission in LA...

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Veröffentlicht in:Journal of cardiovascular electrophysiology 2021-11, Vol.32 (11), p.2961-2970
Hauptverfasser: Pasupula, Deepak Kumar, Munir, Muhammad B., Bhat, Anusha Ganapati, Siddappa Malleshappa, Sudeep K., Meera, Srinidhi J., Spooner, Michael, Koranne, Ketan, Olshansky, Brian, Hirji, Sameer, Hsu, Jonathan C.
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Sprache:eng
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Zusammenfassung:Background Left atrial appendage occlusion (LAAO) devices have become a favorable alternative option among nonvalvular atrial fibrillation (AF) patients with long‐term contraindication to anticoagulation. Real‐world experience with postprocedural readmission rates and predictors of readmission in LAAO patients is limited. Objective To assess all‐cause 30‐day readmission rate and predictors of readmission after LAAO procedure in the United States. Method This retrospective observational study included all AF patients undergoing percutaneous LAAO procedures in the United States from January 1, 2016, and December 31, 2017, in the National Readmission Database. The primary outcome measure was all‐cause 30‐day readmission. A propensity score‐matched analysis compared outcomes with a non‐LAAO AF cohort. Result Among 14 024 LAAO procedures (age: 76 ± 8 years; 60.5% males), 9.4% were readmitted within 30‐days and, 0.2% died during their index hospitalization. The most frequent primary diagnosis during readmission among LAAO was gastrointestinal bleeding (12%). The incidence of LAAO procedures increased by 102%. In the multivariate model, gender and CHA2DS2‐VASc failed to predict readmission. Age 55–64 years had lower odds (adjusted odds ratios [aOR]: 0.41; 95% confidence interval [CI]: 0.18–0.94), while drug abuse (aOR: 4.1; 95% CI: 1.34–12.54), and deficiency anemia (aOR: 1.88; 95% CI: 1.12–3.18) had higher odds of readmission. In propensity‐matched cohort, compared to non‐LAAO AF, LAAO patients had lower 30‐day readmission (9.4% vs. 10.98%, p = .002) and all‐cause in‐hospital mortality (0.19% vs. 0.57%, p 
ISSN:1045-3873
1540-8167
DOI:10.1111/jce.15247