Sex-Based Outcomes in Patients Undergoing WATCHMAN Device Implantation

Area of Science:

• Cardiovascular Medicine
• Health Services Research

Background:

• Sex-based disparities in cardiovascular procedure outcomes are well-documented.
• The Watchman device is a common implant for stroke prevention in atrial fibrillation.
• Limited data exists on sex-specific outcomes following Watchman device implantation.

Purpose of the Study:

• To investigate sex-based differences in outcomes among patients undergoing Watchman device implantation.
• To identify if female sex is an independent risk factor for adverse outcomes after this procedure.

Main Methods:

• Retrospective analysis of 12,327 patients from the National Inpatient Sample database (2016-2018).
• Outcomes assessed included inpatient mortality, length of stay (LOS), hospitalization cost (HOC), and periprocedural complications.
• Multivariate regression analysis was used to adjust for potential confounders.

Main Results:

• Female patients were older and had higher rates of hypertension but lower rates of peripheral arterial disease, chronic kidney disease, and diabetes.
• Women faced higher risks for pericardiocentesis and anemia requiring transfusion.
• Unadjusted analysis showed longer LOS and higher inpatient mortality in females; however, adjusted analysis revealed female sex as an independent risk factor only for longer LOS.

Conclusions:

• Female sex is an independent predictor of increased length of stay following Watchman device implantation.
• After adjusting for confounders, inpatient mortality and hospitalization costs were similar between sexes.
• Further research may explore strategies to mitigate the longer LOS observed in female patients.