Outcomes of Watchman Procedure Based on Its Timing, Elective versus Nonelective; Insights From National Readmissions Database
Author Type(s)
Resident/Fellow
Document Type
Abstract
Publication Date
2022
DOI
10.1016/j.jacc.2022.08.467
Journal Title
Journal of the American College of Cardiology
Department
Medicine
Abstract
Background: The Watchman procedure is a minimally invasive elective intervention designed to reduce the risk of strokes that originate in the left atrial appendage (LAA). However, the data on the impact of timing (elective vs nonelective) of the procedure are unknown. Methods: We queried the National Readmission Database from 2016 to 2019 to identify patients who underwent the Watchman procedure and classified them based on the timing of the procedure into elective and nonelective groups. The adjusted OR of in-hospital, 30-day, and 180-day hospitalization outcomes were calculated using chi-square statistics in STAT v.17 software (StataCorp LLC). Results: A total of 54,864 patients were identified; 50,337 (92%) and 4,527 (8%) had elective and nonelective procedures, respectively. There was a significantly lower risk of major adverse cardiac and cerebrovascular events (adjusted OR [aOR]: 0.2; 95% CI: 0.14-0.28), stroke (aOR: 0.12; 95% CI: 0.07-0.18), myocardial infarction (aOR: 0.12; 95% CI: 0.06-0.24), and acute kidney failure (aOR: 0.48; 95% CI: 0.39-0.57), whereas there was no significant difference in in-hospital mortality and heart failure in the elective group compared with the nonelective group at index admission (Figure). The 30-day, 90-day, and 180-day readmission rates were significantly lower (9% vs 11%, 18% vs 24%, and 23% vs 30%, respectively; P < 0.001) along with the lower average length of stay in an elective versus nonelective group. [Formula presented] Conclusion: Nonelective Watchman procedures are associated with worse in-hospital clinical outcomes along with a higher rate of readmissions and longer hospitalization stays. Categories: STRUCTURAL: Left Atrial Appendage Exclusion
Recommended Citation
Sandhyavenu, H., Ishaq, S., Titus, A., Haroon, D. M., Patel, N., Alyami, B., Victor, V., Patel, N., Sattar, Y., & Alraies, M. C. (2022). Outcomes of Watchman Procedure Based on Its Timing, Elective versus Nonelective; Insights From National Readmissions Database. Journal of the American College of Cardiology, 80 (12), B161. https://doi.org/10.1016/j.jacc.2022.08.467
