Key result
LAAC is linked to an 8.2% 30-day unplanned readmission rate regardless of prior stroke or TIA.
Why the study?
The frequency and risk factors associated with readmission after LAAC in patients with and without previous ischemic stroke or TIA were evaluated.
Does a history of previous ischemic stroke or TIA affect the rate of unplanned readmissions after left atrial appendage closure?
Observational (n=12,901)
Yes
Does a history of previous ischemic stroke or TIA affect the rate of unplanned readmissions after left atrial appendage closure?
Unplanned readmissions after LAAC are common (8.2% at 30 days, 18% at 31-180 days) but are not significantly increased by a history of previous stroke or TIA.
Answers are grounded in this paper and cite their sources.
LAAC readmissions occur at similar rates with or without prior stroke/TIA; this cohort analysis leaves open whether targeted interventions can reduce rates.
Background: We examined the frequency and risk factors associated with readmission after left atrial appendage closure (LAAC) in patients with and without previous ischemic stroke and/or transient ischemic attack (TIA). Methods: Hospitalizations for LAAC were identified from the US National Readmission Database, 2016-2018. The primary outcome was the first unplanned readmission after LAAC, with readmission times stratified into those occurring within 0 to 30 days vs within 31 to 180 days. Patients were stratified based on the history of previous stroke and/or TIA. Results: Of 12,901 discharges after LAAC, 28% had previous stroke and/or TIA, and 8.2% had a readmission within 30 days while 18% had a readmission within 31 to 180 days. The rates of in-hospital complications and readmissions at both periods were not significantly different between individuals with vs without previous stroke and/or TIA. Cardiac causes accounted for 28% of readmissions within 30 days and 32% of those within 31 to 180 days, and congestive failure, bleeding, and infections were the most common readmission diagnoses. New stroke and/or TIA accounted for 4% and 6% of the total noncardiac readmissions within 30 days and 31 to 180 days, respectively, and the incidence was higher among those with previous stroke and/or TIA. Female sex and index hospitalization length of stay (LOS) > 1 day were factors independently associated with readmission within 30 days, whereas LOS, diabetes, renal disease, chronic obstructive pulmonary disease, and anemia were among the factors associated with readmissions within 31 to 180 days. Conclusions: Unplanned rehospitalizations were common after LAAC and had similar frequency for patients with vs without previous ischemic stroke and/or TIA. Female sex and index hospitalization LOS > 1 day were among the strongest factors that were independently associated with readmission within 30 days.
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Sparrow et al. (2023) conducted an observational in Left atrial appendage closure (LAAC) (n=12,901). Left atrial appendage closure (LAAC) vs. Patients without previous ischemic stroke and/or TIA was evaluated on First unplanned readmission after LAAC (within 0 to 30 days vs within 31 to 180 days). Left atrial appendage closure was associated with unplanned readmission rates of 8.2% at 30 days and 18% at 31-180 days, with similar frequencies regardless of previous ischemic stroke or TIA.
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