Same‐day discharge for left atrial appendage occlusion procedure: A systematic review and meta‐analysis

Abstract

Introduction: Most patients undergoing a left atrial appendage occlusion (LAAO) procedure are admitted for overnight observation. A same-day discharge strategy offers the opportunity to improve resource utilization without compromising patient safety. We compared the patient safety outcomes and post-discharge complications between same-day discharge versus hospital admission (HA) (>1 day) in patients undergoing LAAO procedure.Methods: A systematic search of MEDLINE and Embase was conducted. Outcomes of interest included peri-procedural complications, re-admissions, discharge complications including major bleeding and vascular complications, ischemic stroke, all-cause mortality, and peri-device leak >5 mm. Mantel-Haenszel risk ratios (RRs) with 95% CIs were calculated.Results: A total of seven observational studies met the inclusion criteria. There was no statistically significant difference between same-day discharge versus HA

Same-Day Discharge After Percutaneous Left Atrial Appendage Occlusion Procedures

“…Indeed, the rate of 30-day post-LAAO procedure complications in our cohort was similar to that reported in larger population level administrative databases and a recent meta-analysis. 4 , 5 , 6 As LAAO procedures are typically performed in elderly individuals on anticoagulant or antithrombotic therapy, with multiple comorbidities, it is not clear if a further reduction in the rate of postprocedure rehospitalization can be achieved regardless of the time spent in hospital. As rehospitalizations may erode the cost savings associated with SDD, further work to evaluate strategies to minimize rehospitalization post-LAAO is suggested.…”

“… 1 This low frequency of procedural complications coupled with the increasing familiarity of physicians managing LAAO patients has resulted in same-day discharge (SDD) post-LAAO procedure. Data on the safety of SDD after LAAO procedures exist and are evolving, 2 , 3 , 4 , 5 with limited data comparing the 30-day outcomes in patients discharged same-day relative to similar patients monitored overnight. In this single-centre retrospective study we report on the feasibility and safety of SDD after LAAO procedure.…”