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• W4377016253 abstract "As the human lifespan continues to lengthen, so too will the incidence of atrial fibrillation and the need for anticoagulation for stroke prevention. However, many of these patients that require anticoagulation are also at high risk of bleeding making left atrial appendage occlusion (LAAO) an attractive option. Studies on the procedural risks in the very elderly are limited and the safety of LAAO in nonagenarians is lacking. To evaluate the safety of LAAO in nonagenarians compared to a younger cohort. We used the National Inpatient Sample (NIS) database from 2016 to 2019 for our analysis. We extracted the patient's baseline characteristics including age, gender, ethnicity, hospital size, and hospital status (teaching vs non-teaching). We used the ICD-10-CM to identify the associated comorbidities that might influence the primary outcome of the study. We defined the severity of comorbid conditions using Charlson's Comorbidity Index (CCI) and Elixhauser Comorbidity Index. Primary outcomes analyzed were in-hospital mortality, in-hospital complications, and length of stay. From 2016 - 2019, a total of 69,355 patients were analyzed. Of those, 1835 patients were ≥ 90 with an average age of 90.1 years and 67,520 patients aged < 90 with an average age of 75.8 years. Of nonagenarians, 53.6% were male and 91.9% were white. Baseline comorbidities were significantly higher in the nonagenarian group. There was no significant difference in overall mortality or length of stay between both groups. Overall mortality was low in both groups (0.3% in patients ≥ 90 versus 0.2% in patients <90, p-value 0.76). The average length of stay for both groups was 1.5 days. Rehab transfer was significantly higher in nonagenarian patients at 5.2% versus 2.7% (p-value 0.005). Procedure-related complications including acute myocardial infarction, pericardial effusion, tamponade, groin complications, stroke, acute kidney injury, pericardiocentesis, and bleeding were not significantly different between groups. Despite higher baseline comorbidities, LAAO in nonagenarians is a safe procedure, without any increased risk of mortality, major adverse cardiac events, procedure-related complications, or length of hospitalization compared to a younger cohort.Tabled 1Complications and hospital outcomes of patients undergoing left atrial appendage occlusion.Age < 90Age ≥ 90P-ValueLOS (mean)1.5 ±0.031.53 ±0.10.95Mortality (%)0.20.30.76Rehabilitation transfer (%)2.75.20.005In-hospital major adverse eventsAcute kidney injury2.63.80.18Acute myocardial infarction0.40.30.76Acute respiratory failure0.170.540.09Arteriovenous fistula-0.2-Pericardiocentesis1.12.20.06Pericardial effusion3.62.70.38Postprocedural bleeding2.62.70.96Procedure-related complications8.18.50.84Stroke0.00500.67Tamponade0.71.40.13 Open table in a new tab" @default.
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• W4377016253 date "2023-05-01" @default.
• W4377016253 modified "2023-10-18" @default.
• W4377016253 title "PO-03-190 SAFETY AND OUTCOMES OF LEFT ATRIAL APPENDAGE OCCLUSION IN NONAGENARIANS" @default.
• W4377016253 doi "https://doi.org/10.1016/j.hrthm.2023.03.891" @default.
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