Abstract 11539: Causes of Thirty Day Readmissions Following Left Atrial Appendage Closure

Abstract

Introduction: Left Atrial Appendage Occlusion (LAAO) devices provide non pharmacological methods of preventing stroke in patients with atrial fibrillation who cannot tolerate anticoagulation. Data on 30-day readmission measures following LAAO is limited. Methods: Nationwide Readmissions Database from 2016 to 2018 was utilized to identify patients undergoing LAAO. Incidence, prevalence, and causes of readmission were identified. Predictors of 30-day readmission were also identified using complex sample multivariable regression model. Results: Among 29,367 patients receiving LAAO, the average rate of readmission was 9.2%. Readmitted patients were more likely to be females with heart failure, peripheral vascular disease, chronic lung disease, chronic liver disease, and chronic kidney failure especially end stage renal disease (ESRD).The most common overall cause of 30-day readmission was gastrointestinal bleeding (18.5%), followed by heart failure (13.1%), and infection (7.3%) (Figure 1). The odds of readmission were highest in the end stage renal disease patients (OR - 2.75; 95% CI, 2.13 - 3.55; p<0.001) followed by presence of pericardial effusion requiring intervention (OR - 2.13; 95% CI, 1.26 - 3.61; p=0.005) and Stroke/TIA (OR - 1.82; 95% CI, 1.10 - 3.01, p=0.02). Conclusions: The highest odds of readmission were associated with ESRD, periprocedural pericardial effusions requiring intervention, and in hospital stroke/TIA. Gastrointestinal bleeding remained the most common overall cause of readmission, followed by heart failure, and infections. To improve 30-day post-procedural outcomes, further studies are warranted to better identify reversible factors.