Incomplete endothelialization of WatchmanTM Device: Predictors and Implications from Two Cases

Abstract

Atrial fibrillation/flutter (AF/AFL) is a highly prevalent and important risk factor for stroke. Oral anticoagulation offers significant protection against AF/AFL-related thromboembolic events, but severe adverse events such as hemorrhagic stroke (i.e., subarachnoid and intracerebral hemorrhage) may complicate its use [1,2] . There is a paucity of recent data describing costs and consequences of such events. Thus, we sought to estimate in-hospital mortality, length of stay (LOS) and hospital treatment costs for hemorrhagic stroke admissions among United States (US) AF/AFL patients. Material and MethodsThis study used the Agency for Healthcare Research and Quality's (AHRQ's) National Inpatient Sample (NIS) database for the years 2008-2011. The NIS provides a nationally representative ~20% sample of US hospitals and their admissions [3] . We identified adult AF/AFL patients with an International Classification of Diseases, ninth-edition (ICD-9) code of 427.31 or 427.32 (any position) and a primary diagnosis code of 431 or 430 for subarachnoid or intracerebral hemorrhage, respectively. Patients not admitted through the emergency department or transfers from an outside facility were excluded. Endpoints of interest included in-hospital mortality, LOS and hospital treatment costs (in 2015 US dollars). Since all data were de-identified the study did not require institutional review board oversight.