Same-day discharge after LAAO associated with strong outcomes, significant cost savings

Michael Walter | | Cardiovascular Business | Structural Heart Disease
Illustration of a left atrial appendage occlusion (LAAO) procedure using a Watchman device. Image courtesy of Johns Hopkins Medicine. #LAA #LAAO

Illustration of a left atrial appendage occlusion (LAAO) procedure using a Watchman device. Image courtesy of Johns Hopkins Medicine.

Same-day discharge (SDD) after left atrial appendage occlusion (LAAO) is a safe treatment option that does not lead to worse patient outcomes, according to new findings published in the American Journal of Cardiology.[1]

The study’s authors noted that procedural complications after LAAO are quite low, but there is still not much information on the safety and effectiveness of SDD after LAAO. They aimed to learn more by tracking 30-day outcomes found in the Nationwide Readmissions Database (NRD).

The analysis included more than 50,000 LAAO patients treated in the United States from 2016 to 2019. Approximately 1.2% of those patients were discharged on the same day. SDD patients and late discharge patients had similar ages and comorbidities.

Overall, the authors found, the 30-day readmission rates for these two groups were 8% for SDD patients and 9% for late discharge patients. As one might expect, SDD was also linked to significant cost savings ($4,070 per patient).

SDD also became much more common as time went on, increasing from 2 per 1,000 LAAO admissions in 2016 to 19 per 1,000 LAAO admissions in 2019.

“It is interesting to note that there is an increasing trend of same-day discharge from 2016 to 2019,” wrote first author Muhammad Haisum Maqsood, MD, of the department of medicine at Lincoln Medical Center in New York City, and colleagues. “This increase in trend could be attributed to the use of moderate conscious sedation compared with general anesthesia in these patients. This trend of same-day discharge may increase further during the pandemic given the need to preserve hospital beds for patients with COVID-19.”

In February, another analysis highlighting the benefits of SDD after LAAO was published in the Journal of Invasive Cardiology.[2]

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References:

1. Muhammad Haisum Maqsood, MD; Mahmoud Khalil, MD, MSC; AhmedMaraey, MD, et al. Temporal Trends and Outcomes of Same-Day Discharge After Left Atrial Appendage Occlusion: Insight from National Readmission Database. J.amjcard.2022.03.049.

2. Luis Augusto Palma Dallan, Hiram G. Bezerra, Anthony Cochet, et al. Safety, Efficacy, and Cost-Effectiveness of Same-Day Discharge for Left Atrial Appendage Occlusion. J INVASIVE CARDIOL. February 2022. 2022;34(2):E124-E131. ISSN 1557-2501.

Michael Walter
Michael Walter, Managing Editor

Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.

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