Key result
Left atrial appendage closure was associated with an 8.2% 30-day readmission rate, with non-routine disposition, chronic pulmonary disease, renal disease, and anemia as significant predictors.
Why the study?
Determining the incidence and predictors of 30-day readmission after left atrial appendage closure can help direct resources toward high-risk patients.
What are the incidence and predictors of 30-day readmission following left atrial appendage closure?
Cohort (n=2,975)
Yes
What are the incidence and predictors of 30-day readmission following left atrial appendage closure?
Following left atrial appendage closure, 8.2% of patients are readmitted within 30 days, and a simple scoring system based on comorbidities like renal and pulmonary disease can help identify high-risk patients.
May identify high-risk LAA closure patients for targeted follow-up; leaves open whether scoring improves outcomes in prospective validation.
Objective To analyze the incidence, predictors, and cost of 30-day left atrial appendage closure readmissions utilizing the Nationwide Readmissions Database (NRD) and to develop a scoring system to predict readmission risk. Background Determining incidence and predictors of 30-day readmission post-left atrial appendage closure can direct resources towards high-risk patients. Methods International Classification of Diseases, Tenth Revision (ICD-10) codes were used to identify patients. We excluded patients who were discharged or died in December 2016. Influential factors were identified by univariate analysis and clinical suspicion. Continuous variables were compared using the Student’s T-test and categorical variables were compared using chi-square or Fisher’s exact test. A logistic regression model and scoring system were developed and validated. Results 2975 patients were identified and 243 (8.2%) readmitted within 30 days. Non-routine disposition (p<0.0001), chronic pulmonary disease (p=0.0003), renal disease (p<0.0001), and anemia (p=0.009) were significant predictors of readmission. Readmitted patients had longer lengths of stay (2.8 days ± 4.8) and higher charges ($139,869.3 ± 94,574.3). Average length of stay and cost for rehospitalizations were 4.8 days ±4.9 and $62,577± 85,850. Top causes of readmission included atrial fibrillation, atrial flutter, congestive heart failure, sepsis and gastrointestinal bleeding. Mortality during rehospitalization was 1.2%. Our scoring system had a C-statistic of 0.679 (derivation) and 0.633 (validation). Conclusion Readmitted patients have longer and more expensive initial hospital admissions, and chronic cardiac, pulmonary, and renal issues. A simple scoring system may identify patients at risk for readmission
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Ahmed et al. (2020) conducted a cohort in Left atrial appendage closure (n=2,975). Left atrial appendage closure was evaluated on 30-day readmission. Left atrial appendage closure was associated with an 8.2% 30-day readmission rate, with non-routine disposition, chronic pulmonary disease, renal disease, and anemia as significant predictors.
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