Abstract 13454: Utilization Rate and Outcome Trends for Watchman Procedure - Nationwide Analysis

Abstract

Introduction: Left atrial appendage closure is increasingly offered to patients with atrial fibrillation who are poor candidates for long-term anticoagulation. We set out to determine the utilization rates and adjusted outcome trends for the WATCHMAN procedure. Methods: Data were extracted from the National Inpatient Sample (NIS) 2015 through 2019 Database. The NIS was searched for atrial appendage closure in adult patients (age ≥ 18) using ICD 9 and 10 codes. Outcomes of interest were utilization rates of WATCHMAN procedure through time, trends of adjusted mean length of stay (LOS), and adjusted mean cost. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. STATA software was used for analysis. Results: There were 63,190 WATCHMAN procedures performed from 2015 through 2019. The mean patient age was 76 years, and 58% were males. The utilization rates of the WATCHMAN procedure steadily increased from 1800 in 2015 to 26,915 in 2019 (the rise was steeper for females than males and for Caucasians than African Americans). The adjusted mean LOS decreased from 3.4 days to 1.4 days, trend p<0.001. No statistically significant linear trend was observed in terms of adjusted mean hospital cost (32784$ in 2014 vs. 27385$ in 2019, trend p=0.071). Conclusions: There has been a steady rise in the use of WATCHMAN procedure in the United States, more so in females than males and in Caucasians than African Americans. Over the years, there has been a decrease in LOS for WATCHMAN hospitalizations, however, the hospital cost remained unchanged.