Same-day discharge may be safe after LAA closure without complications
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Same-day discharge did not raise risk for readmission in patients with atrial fibrillation who underwent left atrial appendage closure without complications, researchers reported.
The researchers conducted a retrospective cohort study of 48,953 patients (mean age, 76 years; 40% women) with AF who underwent percutaneous left atrial appendage (LAA) closure for stroke prevention from 2015 to November 2019 and did not have any periprocedural complications.
Among the cohort, 1.99% were discharged on the same day of the procedure. Using a propensity score analysis, the researchers matched 961 patients discharged on the same day with 961 patients who did not have same-day discharge.
The outcome of interest, 30-day readmission rate, did not differ between the matched groups (same-day discharge, 8.5%; overnight stay, 9.8%; P = .31), and same-day discharge was not associated with 30-day readmission (HR = 1.13; 95% CI, 0.78-1.63; P = .53), Iwanari Kawamura, MD, postdoctoral fellow at Icahn School of Medicine at Mount Sinai, and colleagues wrote.
The most common cause of readmission was gastrointestinal bleeding, but incidence did not differ between the groups (P = .95), according to the researchers.
“Given that gastrointestinal bleeding was not anticipated for a different readmission rate between the two protocols, we examined the readmission rates and indications for readmission when excluding gastrointestinal bleeding as a cause of readmission,” the researchers wrote. “These additional analyses demonstrated consistent findings to those of the entire cohort.”
Total health care costs required during hospitalization were $23,720 in the same-day discharge group and $25,877 in the overnight stay group (P < .01), Kawamura and colleagues found.
“In addition to the cost-benefit, same-day discharge protocol would be highly beneficial for hospital resource utilization (eg, staff room, medical supply, etc) and patient satisfaction,” the researchers wrote.
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