Outcomes of Left Atrial Appendage Occlusion in Hispanic/Latino Patients: Insights From the National Inpatient Sample

Abstract

Background

Left atrial appendage occlusion (LAAO) is an established therapy for stroke prevention in non-valvular atrial fibrillation (NVAF), but outcomes in Hispanic populations remain underexplored.

Objective

The objective of our study was to evaluate the inpatient outcomes of Hispanic patients undergoing LAAO as compared to non-Hispanic white patients.

Methods

We conducted a retrospective cohort study using the National Inpatient Sample (NIS). From 157 434 LAAO hospitalizations identified, 133 517 were non-Hispanic white and 6814 were Hispanic/Latino. The primary outcome was in-hospital mortality.

Results

Unadjusted odds in the Hispanic/Latino group were higher for mortality (OR 1.78, 95% CI 1.18−2.68, p 0.006), stroke (OR 1.64, 95% CI 1.26−2.14, p < 0.001), infectious complications (OR 3.89, 95% CI 3.03−4.99, p < 0.001), major bleeding (OR 1.22, 95% CI 1.11−1.33, p < 0.001), DVT/PE (OR 2.15, 95% CI 1.58−2.93, p < 0.001), and vascular complications (OR 1.81, 95% CI 0.53−0.93, p < 0.001). After adjusting for covariates and comorbidities, Hispanic/Latino patients had still greater odds of mortality (aOR 1.20, 95% CI 0.75−1.92, p 0.445), infectious complications (aOR 3.54, 95% CI 2.62−4.55, p < 0.001), and vascular complications (aOR 1.57, 95% CI 1.22−2.03, p < 0.001). Non-Hispanic white patients had higher adjusted odds of pericardial effusion/tamponade (aOR 0.64, 95% CI 0.52−0.95, p 0.03), while Hispanic/Latino patients also had higher adjusted odds of cardiac arrest (aOR 1.99, 95% CI 1.15−3.42, p 0.46).

Conclusion

Hispanic/Latino patients undergoing LAAO experience higher odds of infectious and vascular complications compared to non-Hispanic white patients. These findings highlight the need to further investigate disparities in procedural outcomes.