Utilization and short-term outcomes of percutaneous left atrial appendage occlusion in patients with cancer.

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Cardio-oncology Pub Date : 2023-11-04 DOI:10.1186/s40959-023-00192-z
Yaqi Zhang, Zhuoran Yang, Muhammad U Almani, Raquel Soon-Shiong, Bolun Liu
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Abstract

Background: Percutaneous left atrial appendage occlusion (LAAO) has been rapidly evolving since FDA's approval in 2015 and has become more of a same-day-discharge procedure. Cancer patient with atrial fibrillation/flutter (AF) population can benefit from the procedure but the in-hospital outcomes and readmission data were rarely studied.

Objectives: We investigated the utilization, in-hospital and readmission outcomes in cancer patients with AF who underwent LAAO.

Methods: Data were derived from the National Inpatient Sample and National Readmissions Database from 2016 to 2019. Patients with primary diagnosis of AF admitted for LAAO (ICD-10 code 02L73DK) were grouped by cancer as a secondary diagnosis. We assessed in-hospital mortality, length of stay, total hospital charges, and complications. Thirty-day readmission rates were compared.

Results: LAAO was performed in 60,380 patients with AF and 3% were cancer patients. There were no differences in in-hospital mortality and total hospital charges; however, cancer patients tended to have longer hospital stay (1.59 ± 0.11 vs. 1.32 ± 0.02, p = 0.013). Among complications, cancer patients had higher rates in open or percutaneous pericardial drainage (adjusted odds ratio [aOR] 2.38; 95% confidence interval [CI] 1.19-4.76) and major bleeding events (aOR 7.07; 95% CI 1.82-27.38). There was no statistical significance of 30-day readmission rates between patients with and without cancer (10.0% vs. 9.1%, p = 0.34). The most common readmission reason in cancer patients was gastrointestinal bleeding.

Conclusions: LAAO is a promising procedure in cancer patients complicated by AF with contraindication to anticoagulation. Readmission rate is comparable between patients with and without cancer.

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癌症患者经皮左心耳封堵术的应用及近期疗效。
背景:自2015年美国食品药品监督管理局批准以来,经皮左心耳封堵术(LAAO)一直在快速发展,并已成为更多的当天出院程序。患有心房颤动/扑动(AF)人群的癌症患者可以从该手术中受益,但住院结果和再入院数据很少研究。目的:我们调查了接受LAAO的癌症房颤患者的利用率、住院和再入院结果。方法:数据来源于2016年至2019年全国住院患者样本和全国自述数据库。原发诊断为房颤的LAAO患者(ICD-10代码02L73DK)按癌症分组作为二级诊断。我们评估了住院死亡率、住院时间、总住院费用和并发症。比较了30天的再入院率。结果:60380例房颤患者行LAAO,3%为癌症患者。住院死亡率和总住院费用没有差异;然而,癌症患者的住院时间往往更长(1.59 ± 0.11对1.32 ± 0.02,p = 在并发症中,癌症患者有较高的开放或经皮心包引流率(调整比值比[aOR]2.38;95%置信区间[CI]1.19-4.76)和主要出血事件(aOR7.07;95%CI1.82-27.38) = 癌症患者最常见的再入院原因是消化道出血。结论:对于有抗凝禁忌证的癌症合并房颤患者,LAAO是一种很有前途的治疗方法。癌症和非癌症患者的再移植率相当。
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来源期刊
Cardio-oncology
Cardio-oncology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
5.00
自引率
3.00%
发文量
17
审稿时长
7 weeks
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