Long-term Clinical Outcomes in Contemporary Patients Undergoing Left Atrial Appendage Occlusion Procedures in Ontario, Canada
Bibliographic record
Abstract
Background Percutaneous left atrial appendage occlusion (LAAO) is an alternative for stroke prevention in patients with atrial fibrillation (AF) with contraindications to oral anticoagulation (OAC). Population level real-world data describing the use and outcomes of LAAO procedures are evolving with a paucity of longer-term follow-up data. We report on the patient characteristics, procedure complications, and longer-term clinical outcomes in all patients undergoing LAAO procedures in Ontario, Canada. Methods All patients undergoing LAAO procedure between April 1 st 2013 and March 31 st 2022 were identified. Linked administrative databases were utilized to determine patient clinical and procedural characteristics. Outcomes of interest included procedure complications at 7 and 30 days and longer-term rates of stroke, bleeding, all-cause re-hospitalization and mortality. Results 549 individuals were included in the study cohort. The average age was 75±8 years, with 66% male sex, a mean CHA 2 DS 2 VASc score of 4.4±1.6, and 68% were not receiving oral anticoagulation. Follow-up for 2.6±2.0 patient-years was available. Stroke occurred in 2.8% during the follow-up period (1.1/100 patient-years), bleeding in 10% (4.0/100 patient-years) and any hospital re-admission in 63% (43/100 patient-years). 29% of the cohort died during the follow-up period (11/100 patient-years) with 1.8% of the cohort dying during the procedural hospitalization. The mortality rate was unchanged during the study period (p for trend=0.72). Conclusions Long-term stroke and bleeding rates are low in patients undergoing LAAO in Ontario, Canada. All-cause mortality in this population is high and remained unchanged during the study period.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".