Prolonged hospitalization (≥2 days) occurred in 11.5% of LAAO patients, with female gender (OR 1.36), chronic kidney disease (OR 1.82), and Medicaid insurance (OR 1.92) as significant predictors.
Observational (n=5,582)
Yes
Specific demographic, clinical, and socioeconomic factors independently predict prolonged hospitalization after LAAO, providing opportunities to optimize patient selection and perioperative care.
Abstract Introduction Left atrial appendage occlusion (LAAO) has emerged as an important alternative to long-term oral anticoagulation for stroke prevention in patients with atrial fibrillation. While LAAO is typically performed as a minimally invasive procedure with short hospital stays, certain patients experience prolonged hospitalization, leading to increased healthcare costs and potential complications. Understanding the predictors of extended hospital stays is crucial for optimizing patient selection and perioperative care. Purpose To identify demographic, clinical, and institutional factors associated with prolonged hospitalization (≥2 days) following LAAO procedures using a large national database. Methods Using the National Inpatient Sample (NIS) 2020 dataset, we identified patients who underwent LAAO procedures through ICD-10 codes. Prolonged hospital stay was defined as ≥2 days post-procedure. Multivariable logistic regression analysis was performed to identify independent predictors of extended hospitalization. The analysis included demographic characteristics, comorbidities, and hospital-related factors. Results Of 5,582 patients who underwent LAAO, 644 (11.5%) experienced prolonged hospitalization. The analysis revealed several independent predictors of extended stay. Among demographic factors, female gender (OR 1.36, 95% CI 1.15-1.62, p0.001) and Hispanic ethnicity (OR 1.54, 95% CI 1.04-2.24, p=0.032) were significant predictors. Clinical comorbidities showing strong associations included chronic kidney disease (OR 1.82, 95% CI 1.48-2.23, p0.001), chronic obstructive pulmonary disease (OR 1.48, 95% CI 1.22-1.81, p0.001), pulmonary hypertension (OR 1.44, 95% CI 1.07-1.94, p=0.017), and chronic heart failure (OR 1.56, 95% CI 1.24-1.95, p0.001). Healthcare system factors also played a significant role, with Medicaid insurance (OR 1.92, 95% CI 1.09-3.39, p=0.025) and non-metropolitan hospital setting (OR 1.90, 95% CI 1.02-3.57, p=0.045) being associated with longer stays. Conclusion This comprehensive analysis identifies several patient-specific and healthcare system-related factors associated with prolonged hospitalization after LAAO. These findings can help clinicians better identify high-risk patients, optimize pre-procedure preparation, and develop targeted strategies to reduce length of stay. The impact of socioeconomic and healthcare access factors suggests opportunities for system-level interventions to improve care delivery and outcomes.Prolonged Stay Risk Factors
Saeedullah et al. (2025) conducted an observational in Atrial fibrillation (n=5,582). Left atrial appendage occlusion (LAAO) was evaluated on Prolonged hospitalization (≥2 days post-procedure). Prolonged hospitalization (≥2 days) occurred in 11.5% of LAAO patients, with female gender (OR 1.36), chronic kidney disease (OR 1.82), and Medicaid insurance (OR 1.92) as significant predictors.