Objective This manuscript aims to explore the impact of race/ethnicity and socioeconomic status on in-hospital complication rates after left atrial appendage closure (LAAC). Methods The US National Inpatient Sample was used to identify hospitalisations for LAAC between 1 October 2015 to 31 December 2018. These patients were stratified by race/ethnicity and quartiles of median neighbourhood income. The primary outcome was the occurrence of in-hospital major adverse events, defined as a composite of postprocedural bleeding, cardiac and vascular complications, acute kidney injury and ischaemic stroke. Results Of 6478 unweighted hospitalisations for LAAC, 58% were male and patients of black, Hispanic and ‘other’ race/ethnicity each comprised approximately 5% of the cohort. Adjusted by the older Americans population, the estimated number of LAAC procedures was 69.2/100 000 for white individuals, as compared with 29.5/100 000 for blacks, 47.2/100 000 for Hispanics and 40.7/100 000 for individuals of ‘other’ race/ethnicity. Black patients were ~5 years younger but had a higher comorbidity burden. The primary outcome occurred in 5% of patients and differed significantly between racial/ethnic groups (p<0.001) but not across neighbourhood income quartiles (p=0.88). After multilevel modelling, the overall rate of in-hospital major adverse events was higher in black patients as compared with whites (OR: 1.60, 95% CI 1.22 to 2.10, p<0.001); however, the incidence of acute kidney injury was higher in Hispanics (OR: 2.19, 95% CI 1.52 to 3.17, p<0.001). No significant differences were found in adjusted overall in-hospital complication rates between income quartiles. Conclusion In this study assessing racial/ethnic disparities in patients undergoing LAAC, minorities are under-represented, specifically patients of black race/ethnicity. Compared with whites, black patients had higher comorbidity burden and higher rates of in-hospital complications. Lower socioeconomic status was not associated with complication rates. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

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接受左心耳封堵术的患者的种族、民族和社会经济差异

目的 本手稿旨在探讨种族/民族和社会经济地位对左心耳封堵 (LAAC) 后院内并发症发生率的影响。方法 美国全国住院患者样本用于确定 2015 年 10 月 1 日至 2018 年 12 月 31 日期间 LAAC 的住院情况。这些患者按种族/民族和邻里收入中位数的四分位数进行分层。主要结局是院内主要不良事件的发生，定义为术后出血、心脏和血管并发症、急性肾损伤和缺血性中风的复合事件。结果 在 6478 例 LAAC 未加权住院治疗中，58% 为男性，黑人、西班牙裔和“其他”种族/族裔的患者各占队列的约 5%。根据美国老年人口调整，白人个体的 LAAC 程序估计数量为 69.2/100 000，而黑人为 29.5/100 000，西班牙裔为 47.2/100 000，“其他”种族/族裔的个体为 40.7/100 000。黑人患者年轻约 5 岁，但合并症负担更高。主要结果发生在 5% 的患者中，并且在种族/民族之间存在显着差异（p<0.001），但在社区收入四分位数之间没有显着差异（p=0.88）。多水平建模后，黑人患者的院内主要不良事件的总体发生率高于白人（OR：1.60，95% CI 1.22 至 2.10，p<0.001）；然而，西班牙裔美国人的急性肾损伤发生率更高（OR：2.19，95% CI 1.52 至 3.17，p<0.001）。收入四分位数之间调整后的总体住院并发症发生率没有显着差异。结论 在这项评估接受 LAAC 的患者的种族/族裔差异的研究中，少数民族的代表性不足，特别是黑人种族/族裔患者。与白人相比，黑人患者有更高的合并症负担和更高的住院并发症发生率。较低的社会经济地位与并发症发生率无关。与研究相关的所有数据都包含在文章中或作为补充信息上传。黑人患者有更高的合并症负担和更高的院内并发症发生率。较低的社会经济地位与并发症发生率无关。与研究相关的所有数据都包含在文章中或作为补充信息上传。黑人患者有更高的合并症负担和更高的院内并发症发生率。较低的社会经济地位与并发症发生率无关。与研究相关的所有数据都包含在文章中或作为补充信息上传。