Same-Day Discharge after Percutaneous Left Atrial Appendage Closure: Insights from the Nationwide Readmission Database 2015-2019

• Published in: Current problems in cardiology Vol. 48; no. 5; p. 101588
• Main Authors: Zahid, Salman, Hashem, Anas, Rai, Devesh, Khan, Muhammad Zia, Ullah, Waqas, Gowda, Smitha, Munir, Muhammad Bilal, Tan, Bryan E-Xin, Velagapudi, Poonam, Naidu, Srihari, Goel, Sachin, Bhatt, Deepak L., Depta, Jeremiah P.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2023
• Subjects: Atrial Appendage - surgery; Atrial Fibrillation - complications; Atrial Fibrillation - epidemiology; Atrial Fibrillation - surgery; Cardiac Surgical Procedures; Hospitalization; Humans; Patient Discharge; Patient Readmission; Treatment Outcome; ESRD; NRD; VTE; CAD; ICD; UTI; PPM; AVF; SDD; LAAC; ScD; PCI; HB; CABG; CKD; Myocardial Infarction (MI) NDD; AKI; PSA
• ISSN: 0146-2806; 1535-6280
• DOI: 10.1016/j.cpcardiol.2023.101588

Data on the feasibility of same-day discharge (SDD) following percutaneous left atrial appendage closure (LAAC) remain limited. We analyzed the US Nationwide Readmission Database from quarter four of 2015 to 2019 to study the safety and feasibility of SDD after LAAC. After excluding non-elective cases and in-hospital deaths, a total of 54,880 cases of LAAC were performed during the study period. Following LAAC, 2% (n=1077) of patients underwent SDD, 88% (n=48,428) underwent next-day discharge (NDD), 5.2% (n=2881) were discharged on the second day (ScD), and 4.5% of patients (n = 2494) were discharged 3 or more days after LAAC. There was no difference in 30-day readmission rates between SDD and NDD (7.3% [n=79] vs 7.4% [n=3585], P=0.94). The hospitalization costs were significantly lower for SDD compared with NDD ($22,963 vs $27,079, P≤0.01). SDD discharge following percutaneous LAAC appears to be safe and is associated with lower hospitalization costs. Further prospective studies are needed to determine the safety and feasibility of SDD with percutaneous LAAC. [Display omitted] What is New?•Thirty-day readmission and complication rates for same-day discharge (SDD) are comparable with next-day discharge (NDD) after LAAC.•Utilization of SDD remained low throughout the study period as opposed to NDD which was more common.•Hospitalization costs are significantly lower with SDD compared NDD following LAAC. What are the Clinical Implications?•SDD LAAC appear to be safe, feasible, and cost saving.