Conclusion
LAAC is a safe and effective procedure that has a comparably lower rate
of readmission relative to other cardiac procedures, with non-routine
disposition, chronic pulmonary disease, renal disease, and anemia
emerging as risk factors for 30-day readmission. Important causes of
readmission include arrhythmia, GI hemorrhage, heart failure, and
sepsis. Understanding these risk factors may help dictate
resource-utilization and further reduce both costs and readmission
rates. As the burden of atrial fibrillation grows and use of
non-pharmacologic methods of stroke prevention increase, development of
strategies to help reduce readmission rates after LAAC are crucial to
help reduce healthcare costs and increase cost-effectiveness.
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Figure 1. Flowchart delineating selection criteria for index LAAC
hospitalizations.
Table 1. Baseline characteristics, charges, and in-hospital outcomes of
patients readmitted and not readmitted for LAAC procedures.
Figure 2. Multivariable model of 30-day readmissions in patients
undergoing LAAC procedures. Parentheses indicate 95% confidence
intervals.
Figure 3. Broad categories for primary diagnosis of 30-day LAAC
readmissions
Figure 4. Multivariable model of 30-day readmissions in patients
undergoing LAAC procedures with scoring system integrated. Parentheses
indicate 95% confidence intervals.
Table 2. Top 10 causes of 30-day readmissions in patients undergoing
LAAC procedures sorted by percentage and primary diagnosis
Figure 5. Readmission scoring model correlating likelihood of
readmission within 30 days with numerical score using the derivation
cohort.
Figure 6. Readmission scoring model correlating likelihood of
readmission within 30 days with numerical score using the validation
cohort.
Table 3. Peri-procedural complication rates for LAAC procedures.