Arrhythmias & electrophysiologyCohort study
Safety and Efficacy of Combining Left Atrial Appendage Occlusion With Another Cardiac Procedure
- Retrospective cohort study
- National Inpatient Sample 2016–2020
- risk-adjusted
Authors' conclusion
In this retrospective observational study, combining LAAO with another cardiac intervention appeared to be associated with similar MACEs and LOS. However, certain complications appeared to be more frequent, and the cost was higher with combined procedures.
Study context
- Population
- Patients undergoing Left Atrial Appendage Occlusion (LAAO), US National Inpatient Sample 2016–2020
- Participants
- 88,910 weighted encounters
- Exposure
- LAAO combined with another cardiac procedure vs isolated LAAO
- Concomitant proceduren = 1,225
Main finding
MACE (risk-adjusted) · in-hospital
Adjusted odds ratio
1.82
95% CI 0.94–2.74
Concomitant procedure vs Isolated LAAO
adjusted OR 1.82 (95% CI 0.94–2.74)
As reported in the abstract
Observational data: associations, not effects.
Further findings
Length of stay
P = 0.32
| Outcome | Concomitant procedure | Isolated LAAO | P value |
|---|---|---|---|
| Total costs | $44,723 | $32,364 | P < 0.01 |
| LOS and costs vs LAAO with sequential procedures — Concomitant procedure vs LAAO with sequential procedures · LOS 1 day vs 2 days | P < 0.01 | ||
| LOS and costs vs LAAO with sequential procedures — Concomitant procedure vs LAAO with sequential procedures · costs $51,552 vs $63,170 | P = 0.04 |
In-hospital mortality and complications (stroke, AKI, major bleeding, transfusion, vascular injury)
- Similar adjusted odds vs isolated LAAO
Safety
Complications by concomitant procedure (subgroups)
- Concomitant AF/atrial flutter ablation: higher adjusted odds of heart block
- P < 0.01
- Concomitant TAVR: higher adjusted odds of stroke
- P = 0.02
- Concomitant TAVR: higher adjusted odds of vascular injury
- P < 0.01
Original publication
Safety and Efficacy of Combining Left Atrial Appendage Occlusion With Another Cardiac Procedure. JACC Cardiovasc Interv. Published 22 January 2024. doi:10.1016/j.jcin.2023.10.017
Summarised from the published abstract; every number is checked against it