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Sex-Based Differences in Cardiovascular Outcomes Among Patients with Atrial Fibrillation Undergoing Left Atrial Appendage Occlusion Device Placement.
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  • Nadhem Abdallah,
  • Abdilahi Mohamoud,
  • Talal Almasri,
  • Rehan Karim
Nadhem Abdallah
Hennepin County Medical Center

Corresponding Author:[email protected]

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Abdilahi Mohamoud
Hennepin County Medical Center
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Talal Almasri
Hennepin County Medical Center
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Rehan Karim
University of Minnesota Twin Cities Hennepin-University Partnership
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Abstract

Background: There is a growing body of data to support the presence of sex disparities in outcomes of cardiovascular related hospitalizations. Despite this, there remains a paucity of data on relationships between sex and in-hospital outcomes in patients receiving a left atrial appendage occlusion device (LAAOD). Methods: We examined the 2016-2020 Nationwide Readmission Database to identify patients with Atrial Fibrillation receiving a LAAOD. Men were used as our control group, while women comprised our cohort. The primary outcome was inpatient mortality. Secondary outcomes included odds of mechanical ventilation use, all cause 30-day readmission, cardiogenic shock, pericardial complications, length of stay (LOS) and total hospitalization charges (THC). Multivariate linear and logistic regression models were used to adjust for confounders. Results: Among the patients with Atrial fibrillation receiving LAAOD (N = 59,655), 43% were Female. A Female sex was associated with higher odds of inpatient mortality (adjusted OR [aOR] 1.92, 95% CI 1.04 – 3.5), cardiogenic shock (aOR 4.07, 95% CI 1.82 – 9.1), mechanical ventilation use (aOR 2.02, 95% CI 1.4 – 2.9), all cause 30-day readmission (aOR 1.33, 95% CI 1.22 – 1.45), pericardial complications (aOR 2.5, 95% CI 1.83 – 3.3), longer LOS (1.34 vs 1.19 days, p<0.001) and lower THC ($116,330 vs. $121,1870, p<0.001) compared to male patients receiving a LAAOD. Conclusion: Among patients with Atrial Fibrillation receiving a LAAOD, a female sex was associated with higher odds of mortality, non-fatal adverse events, and lower resource utilization compared to male patients.