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Outcomes of Elderly Patients Undergoing Left Atrial Appendage Closure

BACKGROUND: Elderly patients have a higher burden of comorbidities that influence clinical outcomes. We aimed to compare in‐hospital outcomes in patients ≥80 years old to younger patients, and to determine the factors associated with increased risk of major adverse events (MAE) after left atrial app...

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Autores principales: Sanjoy, Shubrandu S., Choi, Yun‐Hee, Sparrow, Robert T., Jneid, Hani, Dawn Abbott, J., Nombela‐Franco, Luis, Azzalini, Lorenzo, Holmes, David R., Alraies, M. Chadi, Elgendy, Islam Y., Baranchuk, Adrian, Mamas, Mamas A., Bagur, Rodrigo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649147/
https://www.ncbi.nlm.nih.gov/pubmed/34558289
http://dx.doi.org/10.1161/JAHA.121.021973
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author Sanjoy, Shubrandu S.
Choi, Yun‐Hee
Sparrow, Robert T.
Jneid, Hani
Dawn Abbott, J.
Nombela‐Franco, Luis
Azzalini, Lorenzo
Holmes, David R.
Alraies, M. Chadi
Elgendy, Islam Y.
Baranchuk, Adrian
Mamas, Mamas A.
Bagur, Rodrigo
author_facet Sanjoy, Shubrandu S.
Choi, Yun‐Hee
Sparrow, Robert T.
Jneid, Hani
Dawn Abbott, J.
Nombela‐Franco, Luis
Azzalini, Lorenzo
Holmes, David R.
Alraies, M. Chadi
Elgendy, Islam Y.
Baranchuk, Adrian
Mamas, Mamas A.
Bagur, Rodrigo
author_sort Sanjoy, Shubrandu S.
collection PubMed
description BACKGROUND: Elderly patients have a higher burden of comorbidities that influence clinical outcomes. We aimed to compare in‐hospital outcomes in patients ≥80 years old to younger patients, and to determine the factors associated with increased risk of major adverse events (MAE) after left atrial appendage closure. METHODS AND RESULTS: The National Inpatient Sample was used to identify discharges after left atrial appendage closure between October 2015 and December 2018. The primary outcome was in‐hospital MAE defined as the composite of postprocedural bleeding, vascular and cardiac complications, acute kidney injury, stroke, and death. A total of 6779 hospitalizations were identified, of which, 2371 (35%) were ≥80 years old and 4408 (65%) were <80 years old. Patients ≥80 years old experienced a higher rate of MAE compared with those aged <80 years old (6.0% versus 4.6%, P=0.01), and this difference was driven by a numerically higher rate of cardiac complications (2.4% versus 1.8%, P=0.09) and death (0.3% versus 0.1%, P=0.05) among individuals ≥80 years old. In patients ≥80 years old, higher odds of in‐hospital MAE were observed in women (1.61‐fold), and those with preprocedural congestive heart failure (≈2‐fold), diabetes (≈1.5‐fold), renal disease (≈2.6‐fold), anemia (≈2.7‐fold), and dementia (≈5‐fold). In patients <80 years old, a higher risk of in‐hospital MAE was encountered among women (≈1.4‐fold) and those with diabetes (≈1.3‐fold), renal disease (≈2.6‐fold), anemia (≈2‐fold), and dyslipidemia (≈1.2‐fold). CONCLUSIONS: Patients ≥80 years old had higher rates of in‐hospital MAE compared with patients aged <80 years old. Female sex and the presence of heart failure, diabetes, renal disease, and anemia were factors associated with in‐hospital MAE among both groups.
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spelling pubmed-86491472022-03-21 Outcomes of Elderly Patients Undergoing Left Atrial Appendage Closure Sanjoy, Shubrandu S. Choi, Yun‐Hee Sparrow, Robert T. Jneid, Hani Dawn Abbott, J. Nombela‐Franco, Luis Azzalini, Lorenzo Holmes, David R. Alraies, M. Chadi Elgendy, Islam Y. Baranchuk, Adrian Mamas, Mamas A. Bagur, Rodrigo J Am Heart Assoc Original Research BACKGROUND: Elderly patients have a higher burden of comorbidities that influence clinical outcomes. We aimed to compare in‐hospital outcomes in patients ≥80 years old to younger patients, and to determine the factors associated with increased risk of major adverse events (MAE) after left atrial appendage closure. METHODS AND RESULTS: The National Inpatient Sample was used to identify discharges after left atrial appendage closure between October 2015 and December 2018. The primary outcome was in‐hospital MAE defined as the composite of postprocedural bleeding, vascular and cardiac complications, acute kidney injury, stroke, and death. A total of 6779 hospitalizations were identified, of which, 2371 (35%) were ≥80 years old and 4408 (65%) were <80 years old. Patients ≥80 years old experienced a higher rate of MAE compared with those aged <80 years old (6.0% versus 4.6%, P=0.01), and this difference was driven by a numerically higher rate of cardiac complications (2.4% versus 1.8%, P=0.09) and death (0.3% versus 0.1%, P=0.05) among individuals ≥80 years old. In patients ≥80 years old, higher odds of in‐hospital MAE were observed in women (1.61‐fold), and those with preprocedural congestive heart failure (≈2‐fold), diabetes (≈1.5‐fold), renal disease (≈2.6‐fold), anemia (≈2.7‐fold), and dementia (≈5‐fold). In patients <80 years old, a higher risk of in‐hospital MAE was encountered among women (≈1.4‐fold) and those with diabetes (≈1.3‐fold), renal disease (≈2.6‐fold), anemia (≈2‐fold), and dyslipidemia (≈1.2‐fold). CONCLUSIONS: Patients ≥80 years old had higher rates of in‐hospital MAE compared with patients aged <80 years old. Female sex and the presence of heart failure, diabetes, renal disease, and anemia were factors associated with in‐hospital MAE among both groups. John Wiley and Sons Inc. 2021-09-24 /pmc/articles/PMC8649147/ /pubmed/34558289 http://dx.doi.org/10.1161/JAHA.121.021973 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Sanjoy, Shubrandu S.
Choi, Yun‐Hee
Sparrow, Robert T.
Jneid, Hani
Dawn Abbott, J.
Nombela‐Franco, Luis
Azzalini, Lorenzo
Holmes, David R.
Alraies, M. Chadi
Elgendy, Islam Y.
Baranchuk, Adrian
Mamas, Mamas A.
Bagur, Rodrigo
Outcomes of Elderly Patients Undergoing Left Atrial Appendage Closure
title Outcomes of Elderly Patients Undergoing Left Atrial Appendage Closure
title_full Outcomes of Elderly Patients Undergoing Left Atrial Appendage Closure
title_fullStr Outcomes of Elderly Patients Undergoing Left Atrial Appendage Closure
title_full_unstemmed Outcomes of Elderly Patients Undergoing Left Atrial Appendage Closure
title_short Outcomes of Elderly Patients Undergoing Left Atrial Appendage Closure
title_sort outcomes of elderly patients undergoing left atrial appendage closure
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649147/
https://www.ncbi.nlm.nih.gov/pubmed/34558289
http://dx.doi.org/10.1161/JAHA.121.021973
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