Predictors of Mortality in Patients With an Implantable Cardiac Defibrillator: A Systematic Review and Meta-Analysis

Alba, A.; Braga, Juarez; Gewarges, M.; Walter, Stephen D.; Guyatt, Gordon; Ross, H.

doi:10.1016/j.cjca.2013.07.144

Cited by 6 publications

(11 citation statements)

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“…Looking at predictors of mortality, a recent review found 72 studies evaluating 63 predictors associated with mortality in ICD patients . Mortality was found to be associated with age and numerous physical variables.…”

Section: Discussionmentioning

confidence: 99%

Anxiety Predicts Mortality in ICD Patients: Results from the Cross‐Sectional National CopenHeart_ICD Survey with Register Follow‐Up

Berg

Thygesen

Svendsen

et al. 2014

Pacing Clinical Electrophis

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Section: Discussionmentioning

confidence: 99%

Anxiety Predicts Mortality in ICD Patients: Results from the Cross‐Sectional National CopenHeart_ICD Survey with Register Follow‐Up

Berg

Thygesen

Svendsen

et al. 2014

Pacing Clinical Electrophis

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“…Several existing risk models leverage patient clinical characteristics to predict short‐term survival in ICD patients . Though this work has demonstrated an increasing risk for death with accumulated comorbidity, calculating risk scores at the bedside may be laborious, and no model has an established role in either clinical practice or research …”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4] Though this work has demonstrated an increasing risk for death with accumulated comorbidity, calculating risk scores at the bedside may be laborious, and no model has an established role in either clinical practice or research. 5 Patient physical activity information is collected automatically by many ICDs. These activity data provide a quantitative, easily accessible measure that may reflect individual functional status.…”

mentioning

confidence: 99%

Patient Activity and Survival Following Implantable Cardioverter‐Defibrillator Implantation: The ALTITUDE Activity Study

Kramer

Mitchell

Monteiro³

et al. 2015

JAHA

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BackgroundPhysical activity data are collected automatically by implantable cardioverter-defibrillators (ICDs). Though these data potentially provide a quantifiable and easily accessible measure of functional status, its relationship with survival has not been well studied.Methods and ResultsPatients enrolled in the Boston Scientific LATITUDE remote monitoring system from 2008 to 2012 with ICDs were eligible. Remote monitoring data were used to calculate mean daily activity at baseline (30 to 60 days after implantation), and longitudinally. Cox regression was used to examine the association between survival and increments of 30 minutes/day in both (1) mean baseline activity and (2) time-varying activity, with both adjusted for demographic and device characteristics. A total of 98 437 patients were followed for a median of 2.2 years (mean age of 67.7±13.1 years; 71.7% male). Mean baseline daily activity was 107.5±66.2 minutes/day. The proportion of patients surviving after 4 years was significantly higher among those in the most versus least active quintile of mean baseline activity (90.5% vs. 50.0%; log-rank P value, <0.001). Lower mean baseline activity (i.e., incremental difference of 30-minutes/day) was independently associated with a higher risk of death (adjusted hazard ratio [AHR], 1.44; 95% confidence interval [CI], 1.427 to 1.462). Time-varying activity was similarly associated with a higher risk of death (AHR, 1.48; 95% CI, 1.451 to 1.508), indicating that a patient having 30 minutes per day less activity in a given month has a 48% increased hazard for death when compared to a similar patient in the same month.ConclusionsPatient activity measured by ICDs strongly correlates with survival following ICD implantation.

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“…Factors associated with this outcome were then identified using logistic regression. First, independent variables potentially associated with NH admission were selected from the data set a priori based on the literature and clinical judgment. Candidate independent variables included age (per 10 years), sex, race (white vs nonwhite), congestive heart failure, NYHA class (using Class I as reference), history of atrial fibrillation or flutter, ischemic heart disease, cerebrovascular disease, replacement ICD, cardiac resynchronization therapy (CRT) (vs non‐CRT device), chronic lung disease, diabetes mellitus, dementia, history of cancer, Medicare Part A claim for NH admission in prior 6 months, left ventricular ejection fraction category (<20%, 20–39% vs ≥40%), and glomerular filtration rate (per 10‐unit increment).…”

Section: Methodsmentioning

confidence: 99%

Nursing Home Use After Implantable Cardioverter‐Defibrillator Implantation in Older Adults: Results from the National Cardiovascular Data Registry

Kramer

Reynolds

Normand

et al. 2016

J American Geriatrics Society

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Background This study evaluated the incidence and characteristics of nursing home (NH) use following ICD implantation. Design Cohort study Setting Medicare patients in the NCDR - ICD Registry. Participants 192,483 patients > 65 years receiving ICDs between January 1, 2006 – March 31, 2010.h Measurements Proportion of ICD recipients discharged to NHs directly after device placement; cumulative incidence of long-term NH admission, and factors associated both with immediate discharge to a NH and time to long-term NH admission. Results Over 4 years, 40.6% of the cohort had died and 35,939 (18.7%) patients experienced at least 1 NH admission, including 4.0% directly discharged to NH following ICD implantation and 2.8% admitted to long-term NH care during follow-up. The cumulative incidence of long-term NH admission, accounting for the competing risk of death, was 1.7% at 1 year, 3.8% at 3 years, and 4.6% at 4 years. A total of 20.1% of patients admitted to NH died in that setting. Factors most strongly associated with direct NH discharge and time to long-term NH care, respectively, included older age (adjusted odds ratio (AOR) 2.09 (95% confidence interval (CI) 2.01 – 2.17) per 10 year increment; and adjusted hazard ratio (AHR) 1.88 (95% CI 1.80–1.97, respectively); dementia (AOR 2.60, (95% CI 2.25–3.01); and AHR 2.50 (95% CI 2.14 – 2.93)); and Medicare Part A claim for NH stay in prior 6 months (AOR 3.96 95% CI 3.70 – 4.25); and AHR 2.88 (95% CI 2.65 – 3.14). Conclusion Nearly 1 in 5 patients are admitted to NHs over a median of 1.6 years of follow-up after ICD implantation. Understanding these outcomes may help inform the clinical care of these patients.

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Predictors of Mortality in Patients With an Implantable Cardiac Defibrillator: A Systematic Review and Meta-Analysis

Cited by 6 publications

References 0 publications

Anxiety Predicts Mortality in ICD Patients: Results from the Cross‐Sectional National CopenHeart_ICD Survey with Register Follow‐Up

Anxiety Predicts Mortality in ICD Patients: Results from the Cross‐Sectional National CopenHeart_ICD Survey with Register Follow‐Up

Patient Activity and Survival Following Implantable Cardioverter‐Defibrillator Implantation: The ALTITUDE Activity Study

Nursing Home Use After Implantable Cardioverter‐Defibrillator Implantation in Older Adults: Results from the National Cardiovascular Data Registry

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Predictors of Mortality in Patients With an Implantable Cardiac Defibrillator: A Systematic Review and Meta-Analysis

Cited by 6 publications

References 0 publications

Anxiety Predicts Mortality in ICD Patients: Results from the Cross‐Sectional National CopenHeartICD Survey with Register Follow‐Up

Anxiety Predicts Mortality in ICD Patients: Results from the Cross‐Sectional National CopenHeartICD Survey with Register Follow‐Up

Patient Activity and Survival Following Implantable Cardioverter‐Defibrillator Implantation: The ALTITUDE Activity Study

Nursing Home Use After Implantable Cardioverter‐Defibrillator Implantation in Older Adults: Results from the National Cardiovascular Data Registry

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Product

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Anxiety Predicts Mortality in ICD Patients: Results from the Cross‐Sectional National CopenHeart_ICD Survey with Register Follow‐Up

Anxiety Predicts Mortality in ICD Patients: Results from the Cross‐Sectional National CopenHeart_ICD Survey with Register Follow‐Up