Readmissions After Left Atrial Appendage Closure in Patients with Previous Ischemic Stroke or Transient Ischemic Attack

Sparrow, Robert T.; Sposato, Luciano A.; Alkhouli, Mohamad A.; García, Santiago; Elgendy, Islam Y.; Kuchtaruk, Adrian A.; Jneid, Hani; Alraies, M. Chadi; Tzemos, Nikolaos; Mamas, Mamas A.; Bagur, Rodrigo

Abstract

Background
We examined the frequency and risk factors associated with readmissions after left atrial appendage closure (LAAC) in patients with and without previous ischemic stroke/transient ischemic attack (TIA).

Methods
Hospitalizations for LAAC were identified from the US NRD 2016-2018. The primary outcome was the first unplanned readmission after LAAC, with readmission times stratified into 0 to 30 days and 31 to 180 days. Patients were stratified based on the history of previous stroke/TIA.

Results
Of 12,901 discharges after LAAC, 28% had previous stroke/TIA, and 8.2% and 18% of eligible patients had a 30-day and 31-180-day readmission, respectively. The rate of in-hospital complications and readmissions at both periods were not significantly different between individuals with previous stroke/TIA or not. Cardiac causes represented 28% of 30-day and 32% of 31-to-180-day readmissions, and congestive failure, bleeding and infections were the most common readmission diagnoses. New stroke/TIA accounted for 4% and 6% of the total non-cardiac readmissions at 30- and 31-to-180-day, respectively, and was higher among those with previous stroke/TIA. Female sex as well as index hospitalization LOS >1 day were factors independently associated with 30-day readmissions, whereas LOS, diabetes, renal disease, COPD, and anemia were among the factors associated with 31-180-day readmission. History of stroke/TIA was among the strongest factors associated with non-cardiac causes of readmission.

Conclusion
Unplanned rehospitalizations were common after LAAC and showed similar frequency for patients with and without previous ischemic stroke/TIA. Female sex as well as index hospitalization length-of-stay >1 day were among the strongest factors which were independently associated with 30-day readmissions.

Citation

Sparrow, R. T., Sposato, L. A., Alkhouli, M. A., García, S., Elgendy, I. Y., Kuchtaruk, A. A., Jneid, H., Alraies, M. C., Tzemos, N., Mamas, M. A., & Bagur, R. (2023). Readmissions After Left Atrial Appendage Closure in Patients with Previous Ischemic Stroke or Transient Ischemic Attack. CJC Open, 5(12), 950-964. https://doi.org/10.1016/j.cjco.2023.09.009

• Journal Article Type: Article
• Acceptance Date: Sep 12, 2023
• Online Publication Date: Sep 17, 2023
• Publication Date: Sep 17, 2023
• Deposit Date: Nov 28, 2023
• Journal: CJC Open
• Electronic ISSN: 2589-790X
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 5
• Issue: 12
• Pages: 950-964
• DOI: https://doi.org/10.1016/j.cjco.2023.09.009
• Public URL: https://keele-repository.worktribe.com/output/583765