Length of stay following percutaneous left atrial appendage occlusion: Data from the prospective, multicenter Amplatzer Amulet Occluder Observational Study

PLoS One. 2021 Aug 10;16(8):e0255721. doi: 10.1371/journal.pone.0255721. eCollection 2021.

Abstract

Aims: To evaluate factors influencing the length of stay in patients undergoing percutaneous left atrial appendage occlusion (LAAO).

Methods and results: Patient characteristics, procedural data and the occurrence of serious adverse events were analyzed from the AmplatzerTM AmuletTM Occluder Observational Study. Patients were divided into three groups: same day (S, 0day, n = 60, 5.6%) early (E, 1day, n = 526, 48.9%), regular (R, 2-3days, n = 338, 31.4%) and late (L, ≥4days, n = 152, 14.1%) discharge and followed up for 60 days. Procedure and device related SAE during the in-hospital stay (S: 0.0% vs. E: 1.0% vs. R: 2.1% vs. L: 23%, p<0.0001) were a major trigger for a prolonged in-hospital stay. Of the 37 subjects in the late discharge group with an SAE prior to discharge, cardiac or bleeding complications were the most common underlying conditions, occurring in 26 subjects. Multinomial logistic analysis only identified HAS-BLED score as an independent influencing factor (p = 0.04) for a late discharge. After 60 days, mortality tended to be greatest in the late discharge group (S: 0.0% vs. E: 1.0% vs. R: 1.2% vs. L: 3.3%, p = 0.1066).

Conclusion: Over half of the subjects receiving an Amplatzer Amulet occluder were discharged within 1 day of the implant procedure. Serious adverse events were a major trigger for a late discharge after LAAO. Increased HAS-BLED score was associated with a prolonged in-hospital stay.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Atrial Appendage / physiopathology*
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / therapy*
  • Cardiac Catheterization / methods
  • Female
  • Heart Disease Risk Factors
  • Hemorrhage / complications
  • Hemorrhage / physiopathology
  • Hemorrhage / therapy*
  • Humans
  • Ischemic Stroke / complications
  • Ischemic Stroke / physiopathology
  • Ischemic Stroke / therapy*
  • Length of Stay
  • Male
  • Septal Occluder Device*
  • Treatment Outcome

Grants and funding

This study was supported by Abbott in the form of salaries for RG and HZ and Harzklinikum Dorothea Christiane Erxleben GmbH in the form of a salary for SF. The specific roles of these authors are articulated in the ‘author contributions’ section. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.