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Impact of Psychosocial Risk Factors on Outcomes of Atrial Fibrillation Patients undergoing Left Atrial Appendage Occlusion Device Implantation

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Abstract

Background

The impact of psychosocial risk factors (PSRFs) on outcomes in patients undergoing percutaneous left atrial appendage occlusion (LAAO) device implantation is unclear. We aimed to analyze the association of psychosocial risk factors with outcomes in patients undergoing LAAO.

Methods

Data were extracted from the Nationwide readmissions database for the calendar years 2016-2019. LAAO device implantations were identified using ICD-10-CM code 02L73DK. The outcomes of interest included procedural complications, inpatient mortality, resource utilization, and 30-day readmissions. Patients were divided into two cohorts based on the absence or presence of PSRFs.

Results

Our cohort included a total of 54,900 patients, of which, 19,984 (36.4%) had ≥ 1 PSRF as compared to 34,916 (63.6%) with no PSRFs. The prevalence of major complications (3.3% vs 2.8%, p=0.03) was significantly higher in patients with ≥ 1 PSRF as compared to no PSRFs. Furthermore, patients with ≥ 1 PSRF had a significantly higher 30-day readmission rate (6.9% vs 6.2%, p=0.02). In the multivariable model, the presence of ≥ 1 PSRF was associated with significantly higher odds of overall complications [adjusted odds ratio (aOR):1.11; 95% confidence interval (CI): 1.01-1.21; p=0.02]. Additionally, the presence of ≥ 1 PSRF was associated with higher odds of prolonged hospital stay for more than one day (aOR: 1.30; 95% CI: 1.21-1.40; p<0.01).

Conclusion

The high prevalence of PSRFs may be associated with poorer outcomes in patients with AF patients undergoing LAAO device implantations. These data merit further study to help in the selection process of patients for LAAO for improved outcomes.

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Acknowledgments

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    Siddharth Agarwal, Stavros Stavrakis & Zain Ul Abideen Asad

  2. Division of Cardiovascular Medicine, University of California Davis, Sacramento, CA, USA

    Muhammad Bilal Munir

  3. Department of Cardiovascular Medicine, West Virginia University Heart & Vascular Institute, Morgantown, WV, USA

    Muhammad Zia Khan

  4. Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA

    Agam Bansal

  5. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA

    Abhishek Deshmukh & Christopher V. DeSimone

Authors
  1. Siddharth Agarwal
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Correspondence to Zain Ul Abideen Asad.

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Due to the de-identified nature of the NRD dataset, the need for informed consent and Institutional Review Board approval is waived.

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Agarwal, S., Munir, M.B., Khan, M.Z. et al. Impact of Psychosocial Risk Factors on Outcomes of Atrial Fibrillation Patients undergoing Left Atrial Appendage Occlusion Device Implantation. J Interv Card Electrophysiol 66, 2031–2040 (2023). https://doi.org/10.1007/s10840-023-01546-4

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