Yuki Sahashi1,2,3, Toshiki Kuno4,5, Yoshihiro Tanaka6,7, Rod Passman6,7, Alexandros Briasoulis8, Aaqib H Malik9. 1. Department of Cardiovascular Medicine, Gifu Heart Center, 4-14-4, Yabutaminami, Gifu 500-8384, Japan. 2. Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan. 3. Department of Health Data Science, Graduate School of Data Science, Yokohama City University, Yokohama, Japan. 4. Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA. 5. Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA. 6. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 7. Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 8. Division of Cardiovascular Diseases, University of Iowa Hospitals and Clinics, Iowa City, IA, USA. 9. Division of Cardiology, Westchester Medical Center, Valhalla, NY, USA.
Abstract
AIMS: The effectiveness and safety of same-day discharge (SDD) for catheter ablation (CA) for atrial fibrillation (AF) has not been fully elucidated using a large nationwide database. This study aimed to evaluate the all-cause readmission rates within 30-days among patients receiving CA for AF with an SDD protocol compared with a conventional overnight stay (ONS). METHODS AND RESULTS: We performed a retrospective cohort study using the US Nationwide Readmission Database. The primary outcome was all-cause 30-day readmission following discharge in patients receiving CA and a secondary outcome was requiring total healthcare cost. A 1 : 3 propensity score matching was conducted to compare the safety and efficacy within both SDD and ONS group. Among 30 776 patients [mean 67.2 ± 11.4 years, 12 590 female (41.5%)] who received CA from 2016 through 2018, 440 (1.42%) patients were discharged on the same-day following CA (SDD group), and the remaining 30 336 patients stayed at least one night in the hospital (ONS group). A propensity score analysis generated 1751 matched pairs (440 in the SDD group; 1311 in the ONS group). The 30-day readmission following discharge was not significantly higher in the SDD group than the ONS group (SDD vs. ONS: 12.7% vs. 9.7%; hazard ratio: 1.17, 95% confidence interval: 0.76-1.81, P = 0.47). Healthcare cost was significantly higher in the ONS group ($25 237 ± 14 036 vs. $30 749 ± 16 383; P < 0.01). CONCLUSION: In this nationwide database study, there was no significant difference in the all-cause 30-day readmission following SDD for CA compared with ONS. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The effectiveness and safety of same-day discharge (SDD) for catheter ablation (CA) for atrial fibrillation (AF) has not been fully elucidated using a large nationwide database. This study aimed to evaluate the all-cause readmission rates within 30-days among patients receiving CA for AF with an SDD protocol compared with a conventional overnight stay (ONS). METHODS AND RESULTS: We performed a retrospective cohort study using the US Nationwide Readmission Database. The primary outcome was all-cause 30-day readmission following discharge in patients receiving CA and a secondary outcome was requiring total healthcare cost. A 1 : 3 propensity score matching was conducted to compare the safety and efficacy within both SDD and ONS group. Among 30 776 patients [mean 67.2 ± 11.4 years, 12 590 female (41.5%)] who received CA from 2016 through 2018, 440 (1.42%) patients were discharged on the same-day following CA (SDD group), and the remaining 30 336 patients stayed at least one night in the hospital (ONS group). A propensity score analysis generated 1751 matched pairs (440 in the SDD group; 1311 in the ONS group). The 30-day readmission following discharge was not significantly higher in the SDD group than the ONS group (SDD vs. ONS: 12.7% vs. 9.7%; hazard ratio: 1.17, 95% confidence interval: 0.76-1.81, P = 0.47). Healthcare cost was significantly higher in the ONS group ($25 237 ± 14 036 vs. $30 749 ± 16 383; P < 0.01). CONCLUSION: In this nationwide database study, there was no significant difference in the all-cause 30-day readmission following SDD for CA compared with ONS. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Benjamin A Steinberg; Shannon Woolley; Haojia Li; Candice Crawford; Christopher A Groh; Leenhapong Navaravong; Ravi Ranjan; Brian Zenger; Yue Zhang; T Jared Bunch Journal: J Cardiovasc Electrophysiol Date: 2022-05-30 Impact factor: 2.942