Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
Division of Cardiovascular Medicine, University of California San Diego, La Jolla, California, USA.
Catheter Cardiovasc Interv. 2021 Apr 1;97(5):885-892. doi: 10.1002/ccd.29282. Epub 2020 Oct 13.
There is insufficient current evidence about whether sex impacts outcomes of percutaneous left atrial appendage occlusion (LAAO). The aim of this study was to investigate the association between sex and short-term outcomes of LAAO.
Patients who were hospitalized and underwent LAAO from October 2015 to December 2017 in the National Readmission Database were queried. The primary endpoint of interest was major in-hospital adverse events. Secondary endpoints included, 30-day readmission rate, nonhome discharge, and cost of hospitalization. Propensity score matching (1:1) was performed to compare the outcomes among women and men.
A total of 9,281 patients were included in the current analysis [women = 3,659 (39%); men = 5,622 (61%)]. Comparing women to men, women had lower prevalence of diabetes mellitus (30.6% vs 35.7%, p < .01), heart failure (28.6% vs 30.8%, p = .03), vascular disease (55.5% vs 69.6%, p < .01) and renal failure (18.3% vs 21.2%, p < .01), and higher CHA DS VASc score (5 [IQR4-6] vs 4 [IQR3-6], p < .01). After propensity-score matching, women had higher rate of major in-hospital adverse events (2.8% vs 1.9%; p < .01), and nonhome discharges (11.4% vs 6.7%; p < .01). Additionally, 30-day readmission rate was higher among women (10% vs 8.6%, p = .03).
Among hospitalized patients undergoing LAAO, women carry higher risk for major in-hospital adverse events, nonhome discharge, and 30-day readmission rates.
目前关于性别是否影响经皮左心耳封堵术（LAAO）的结果的证据不足。本研究的目的是调查性别与 LAAO 短期结果之间的关系。
从 2015 年 10 月至 2017 年 12 月，在美国国家再入院数据库中查询因 LAAO 住院的患者。主要研究终点为主要院内不良事件。次要终点包括 30 天再入院率、非家庭出院率和住院费用。采用倾向评分匹配（1:1）比较女性和男性的结局。
本研究共纳入 9281 例患者[女性 3659 例（39%）；男性 5622 例（61%）]。与男性相比，女性糖尿病患病率较低（30.6%比 35.7%，p < 0.01），心力衰竭（28.6%比 30.8%，p = 0.03），血管疾病（55.5%比 69.6%，p < 0.01）和肾功能衰竭（18.3%比 21.2%，p < 0.01），CHA2DS2-VASc 评分较高（5 [四分位距 4-6] 比 4 [四分位距 3-6]，p < 0.01）。经过倾向评分匹配后，女性主要院内不良事件发生率较高（2.8%比 1.9%；p < 0.01），非家庭出院率较高（11.4%比 6.7%；p < 0.01）。此外，女性 30 天再入院率较高（10%比 8.6%，p = 0.03）。
在接受 LAAO 的住院患者中，女性发生主要院内不良事件、非家庭出院和 30 天再入院的风险较高。
