Mortality after cardioverter-defibrillator replacement: Results of the DECODE survival score index

Zoni-Berisso, Massimo; Martignani, Cristian; Ammendola, Ernesto; Narducci, Maria Lucia; Caruso, Davide; Miracapillo, Gennaro; Notarstefano, Pasquale; Carinci, Valeria; Pierantozzi, Attilio; Ciaramitaro, Gianfranco; Calò, Leonardo; Zennaro, Mauro; Infusino, Tommaso; Ferretti, Carlo; Sassone, Biagio; Licciardello, Giovanni; Setti, Sergio; Terzaghi, Carlotta; Malacrida, Maurizio; Biffi, Mauro

doi:10.1016/j.hrthm.2020.11.024

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…Regarding implantable cardioverter‐defibrillators (ICDs), our results matched two previous studies. The first focused on hospitalizations occurring within 30 days before an ICD therapy replacement and its association with death, 21 and the second reported increasing survival rates in patients at risk of sudden cardiac death due to ventricular tachyarrhythmia ICD therapy 1 . A recently published meta‐analysis pooling data from all randomized control trials and tested primary‐prevention ICD over the past two decades (including the DANISH trial) also confirmed a significant reduction of all‐cause mortality associated with ICD use in patients with non‐ischaemic cardiomyopathy 22 .…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular disease healthcare trajectories: descriptions, similarities, mortality rates of heart failure in France

Nevoret,

Tran,

Guendouz

et al. 2024

ESC Heart Failure

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AimsThe primary objectives of this study were to analyse the nationwide healthcare trajectories of heart failure (HF) patients in France, 2 years after their first hospitalization, and to measure sequence similarities. Secondary objectives were to identify the association between trajectories and the risk of mortality.Methods and resultsA retrospective, observational study was conducted using data extracted from the Echantillon Généraliste des Bénéficiaires database, covering the period from 1 January 2008 to 31 December 2018. Follow‐up concluded upon death or at the end of the study. We developed a methodology specific to healthcare data by extracting frequent healthcare trajectories and measuring their similarity for use in a survival machine learning analysis. In total, 11 488 HF patients were included and followed up for an average of 2.9 ± 1.3 years. The mean age of the patients was 78.0 ± 13.2 years. The first‐year mortality rate was 31.7% and increased to 78.8% at 5 years. Fifty per cent of patients experienced re‐hospitalization for reasons related to cardiovascular diseases. We identified 1707 hospitalization sequences, and 21 sequences were associated with survival, while 15 sequences were linked to mortality. In all our models, age and gender emerged as the most significant predictors of mortality (permutation feature importance: 0.099 ± 0.00078 and 0.0087 ± 0.00018, respectively; weights could be interpreted in relative terms). Specifically, the age at initial hospitalization for HF was positively associated with mortality. Gender (male: 49.5%) was associated with poorer prognoses. Healthcare trajectories, including non‐surgical device treatments, valve replacements, and atrial fibrillation ablation, were associated with a better prognosis (permutation feature importance: 0.0047 ± 0.00011, 0.0014 ± 0.000073, and 0.00095 ± 0.000097, respectively), except in cases where these invasive treatments preceded or followed hospitalization for cardiac decompensation. The predominant negative prognosis sequences were mostly those that included HF‐related hospitalizations before or after other‐related hospitalizations (permutation feature importance: 0.0007 ± 0.000091 and 0.00011 ± 0.000045, respectively).ConclusionsWe highlight the value of healthcare trajectories on frequent hospitalization sequences, mortality, and prognosis and indicate the necessary prognostic value of HF re‐hospitalization. Our work may be an essential tool for better identification of at‐risk patients in order to increase and improve personalized care in the future.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular disease healthcare trajectories: descriptions, similarities, mortality rates of heart failure in France

Nevoret,

Tran,

Guendouz

et al. 2024

ESC Heart Failure

View full text Add to dashboard Cite

show abstract

“…Yet, this is likely a confounding effect, representing an underlying infection, but could also be a proxy for frailer patients, as observed in the DECODE registry, where recent hospital admission prior to CIED reoperations was associated with increased mortality. 41 Nonetheless, it seems reasonable to identify these patients. Two studies have examined different approaches of enhanced antibiotic-regimes in high-risk patients.…”

Section: Discussionmentioning

confidence: 99%

“…Diabetes and the usage of insulin is known to impair both cellular 59 and humoral immunity, 60 and correlates with our findings of increased risk of systemic CIED infections. However, usage of insulin has also been associated with increased mortality in CIED reoperations, 41 and might represent diabetes in an advanced stage, with end-stage complications, favouring bacterial seeding due to skin breaches and repeated vascular entries. Atopic dermatitis and erysipelas are associated with increased risk of bacteraemia 61 and also were found associated with increased risk of systemic CIED infections in our population.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for cardiac implantable electronic device infections: a nationwide Danish study

Olsen

Jørgensen

Nielsen

et al. 2022

European Heart Journal

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Aims Cardiac implantable electronic device (CIED) infection is a severe complication to modern management of cardiac arrhythmias. The CIED type and the type of surgery are recognized as risk factors for CIED infections, but knowledge of patient-related risk factors is scarce. This study aimed to identify lifelong patient-related risk factors for CIED infections. Methods and results Consecutive Danish patients undergoing a CIED implantation or reoperation between January 1996 and April 2018 were included. The cohort consisted of 84 429 patients undergoing 108 494 CIED surgeries with a combined follow-up of 458 257 CIED-years. A total of 1556 CIED explantations were classified as either pocket (n = 1022) or systemic CIED infection (n = 534). Data were cross-linked with records from the Danish National Patient Registry and the Danish National Prescription Registry. Using multiple-record and multiple-event per subject proportional hazard analysis, specific patient-related risk factors were identified but with several variations amongst the subtypes of CIED infection. CIED reoperations were associated with the highest risk of pocket CIED infection but also CIED type, young age, and prior valvular surgery [hazard ratio (HR): 1.62, 95% confidence interval (CI): 1.29–2.04]. Severe renal insufficiency/dialysis (HR: 2.40, 95% CI: 1.65–3.49), dermatitis (HR: 2.80, 95% CI: 1.92–4.05), and prior valvular surgery (HR: 2.09, 95% CI: 1.59–2.75) were associated with the highest risk of systemic CIED infections. Congestive heart failure, ischaemic heart disease, malignancy, chronic obstructive pulmonary disease, and temporary pacing were not significant at multivariate analysis. Conclusion Specific comorbidities and surgical procedures were associated with a higher risk of CIED infections but with variations amongst pocket and systemic CIED infection. Pocket CIED infections were associated with CIED reoperations, young age and more complex type of CIED, whereas systemic CIED infections were associated with risk factors predisposing to bacteraemia.

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Risk scores in cardiac resynchronization therapy–A review of the literature

Boros

Perge

Merkely

2023

Front. Cardiovasc. Med.

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Cardiac resynchronization therapy (CRT) for selected heart failure (HF) patients improves symptoms and reduces morbidity and mortality; however, the prognosis of HF is still poor. There is an emerging need for tools that might help in optimal patient selection and provide prognostic information for patients and their families. Several risk scores have been created in recent years; although, no literature review is available that would list the possible scores for the clinicians. We identified forty-eight risk scores in CRT and provided the calculation methods and formulas in a ready-to-use format. The reviewed score systems can predict the prognosis of CRT patients; some of them have even provided an online calculation tool. Significant heterogeneity is present between the various risk scores in terms of the variables incorporated and some variables are not yet used in daily clinical practice. The lack of cross-validation of the risk scores limits their routine use and objective selection. As the number of prognostic markers of CRT is overwhelming, further studies might be required to analyze and cross-validate the data.

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Mortality after cardioverter-defibrillator replacement: Results of the DECODE survival score index

Cited by 3 publications

References 23 publications

Cardiovascular disease healthcare trajectories: descriptions, similarities, mortality rates of heart failure in France

Cardiovascular disease healthcare trajectories: descriptions, similarities, mortality rates of heart failure in France

Risk factors for cardiac implantable electronic device infections: a nationwide Danish study

Risk scores in cardiac resynchronization therapy–A review of the literature

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