ReviewCureus2025
Impact of Age on Clinical Outcomes Following Left Atrial Appendage Occlusion: A Meta-Analysis And Systematic Review of Observational Studies.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
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Abstract
Left atrial appendage occlusion (LAAO) offers an alternative to oral anticoagulation for stroke prevention in patients with non-valvular atrial fibrillation; however, the impact of advanced age on outcomes remains uncertain. We conducted a systematic review and meta-analysis to evaluate the effect of age on in-hospital and long-term outcomes following LAAO. A comprehensive search of PubMed and Google Scholar yielded 1,372 studies, of which seven met the inclusion criteria after screening and full-text review. Eligible studies stratified outcomes by age (<75 vs ≥75, <80 vs ≥80, or multilevel age groups), and we analyzed all-cause mortality, stroke/systemic embolism (SE), and major bleeding using relative risks (RRs) with 95% confidence intervals (CI). Long-term mortality was significantly higher among older patients, with mortality rising from 32.4% at age 65-69 to 63.4% in those ≥85 (RR 1.96, 95%CI 1.90-2.03), and from 14.3% <80 to 38.8% ≥80 (RR 2.71, 95%CI 2.24-3.28). Pooled analysis demonstrated substantial heterogeneity for mortality (I² = 80.7%). Stroke/SE rates were modestly elevated with age, including 13.0% in ≥85 vs 5.3% at 65-69 (RR 2.45, 95%CI 2.00-3.00), with moderate heterogeneity across studies (I² = 63.9%). Major bleeding consistently increased in older groups, such as 18.4% ≥85 vs 12.0% at 65-69 (RR 1.53, 95%CI 1.35-1.72) and 22.6% ≥80 vs 12.1% <80 (RR 1.87, 95%CI 1.44-2.41), with high heterogeneity (I² = 83.4%). In-hospital mortality and stroke/SE were low overall but showed age-related increases in large cohorts. A funnel plot suggested no major publication bias. LAAO provides consistent stroke prevention across all ages, but older patients, particularly those ≥80-experience significantly higher mortality and bleeding risks. Age should not contraindicate LAAO but should guide individualized risk-benefit discussions, especially regarding bleeding management and long-term prognosis.
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