Abstract
Abstract 9444: Differences in Hospital Outcomes Following Watchman's Procedure Based on CHA2DS2VASc Score: Insight From National Inpatient Sample Database, 2016-2019
Circulation (New York, N.Y.), v 146(Suppl_1), A9444
08 Nov 2022
Abstract
Background: Uncertainty exists whether a higher CHA2DS2VASc risk score is associated with poorer in-hospital outcomes than a lower risk score following Left Atrial Appendage Occlusion (LAAO) procedures.
Methods: The National Inpatient Sample (NIS) was queried for all hospitalizations with primary atrial fibrillation or flutter from 2016 to 2019 with codes for percutaneous left atrial appendage occlusion device placement. Cohorts with high (CHA2DS2VASc ≥5) and low (CHA2DS2VASc <5) risk of stroke were compared. Weighted multivariable logistic regression was used to assess the association between CHA2DS2VASc score and in-hospital outcomes.
Results: Out of 60,350 procedures performed, 50.61% had high CHA2DS2VASc score (> 5) and 49.39% had low score (< 5) (table 1). All patients received the Watchman device. The primary outcome of in-hospital mortality was not statistically different between high and low risk (0.18% vs. 0.12%, OR: 1.53, 95% CI: 0.59-3.96, p=0.37), a finding that did not change when adjusted for comorbidities in multivariate analysis (adjusted OR: 1.44, 95% CI: 0.55-3.62, p=0.46). In the high-risk group, total complication rates were similar (adjusted OR: 1.16, 95% CI: 0.97-1.38, p=0.09) as was ischemic stroke (adjusted OR: 2.05, 95% CI: 0.82-5.13, p=0.13) while systemic embolism (adjusted OR: 5.09, 95% CI: 1.08-23.99, p=0.04) and major bleeding requiring transfusion (adjusted OR: 3.84, 95% CI: 1.41-10.42, p=0.08) were higher after adjusting for confounders in multivariable analysis (figure 1).
Conclusion: This study demonstrates that the LAAO procedure had similar short-term outcomes between high and low-risk patients in a study of real-world patients.
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Details
- Title
- Abstract 9444: Differences in Hospital Outcomes Following Watchman's Procedure Based on CHA2DS2VASc Score: Insight From National Inpatient Sample Database, 2016-2019
- Creators
- Biraj Shrestha - Reading HospitalBidhya Poudel - Saint Francis HospitalAnthony Donato - Reading Hospital
- Publication Details
- Circulation (New York, N.Y.), v 146(Suppl_1), A9444
- Publisher
- American Heart Association
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Medicine (Graduate); General Internal Medicine
- Other Identifier
- 991022161841604721