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., …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
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 5
• Issue: 12
• Pages: 950-964
• DOI: https://doi.org/10.1016/j.cjco.2023.09.009