Comorbidities Vs Age as Major Predictor of Prolonged Length of in-Hospital Stay in Patients Undergoing New Pacemaker Implantation

Abstract

Traditionally, advanced age has been considered a major factor for increased LOS and healthcare costs. However, recent studies suggest that comorbidity may have an equal, if not greater, effect on LOS and mortality as age in a variety of clinical scenarios. The elderly are the most rapidly growing part of the population in developed countries and pacemakers (PM) are commonly implanted in this population. In this retrospective study, we aimed to evaluate the impact of comorbidity on LOS and mortality, as compared to age, in patients undergoing new PM implantation. 257 elective and non-elective patients that underwent new PM implantation were included in the study. The median follow-up time was 20 (15-25) months. A Charlson comorbidity index (CCI) > 1 resulted to be a significant predictor for the excess of LOS, whereas age did not significantly predict excess of LOS. Elderly patients (age > 75 years) with low comorbidity burden (CCI < 1) showed no significant differences with regards to LOS and mortality when compared to younger patients. Considering the findings of our study, when considering patients for PM implantation, comorbidity burden rather than age should be the driving factor in the approach of indication of PM implantation.