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.