Thirty-day readmissions after cardiac implantable electronic devices in the United States: Insights from the Nationwide Readmissions Database

Patel, Brijesh; Sablani, Naveen; Garg, Jalaj; Chaudhary, Rahul; Shah, Mahek; Gupta, Rahul; Nazir, Talha; Bozorgnia, Babak; Padala, Santosh K.; Gunda, Sampath; Ellenbogen, Kenneth A.

doi:10.1016/j.hrthm.2018.01.006

Cited by 13 publications

(17 citation statements)

References 27 publications

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“…4 A recent study reports 30-day readmission rates of 6% and 11% in single-chamber and dual-chamber pacemaker recipients, respectively, where heart failure was the most common cardiac etiology. 17 Most studies do not distinguish between complications occurring in-hospital and those occurring following discharge. As we did not examine in-hospital complications, this may be the reason that the frequency of some complications such as tamponade and pneumothorax was lower than that found in other studies.…”

Section: Resultsmentioning

confidence: 99%

“…In a Danish registry‐based study, 6.9% of single‐chamber and 8.9% of dual‐chamber pacemaker recipients experienced complications over a period of 6 months, ranging from major complications requiring reinterventions to minor complications that were treated conservatively . A recent study reports 30‐day readmission rates of 6% and 11% in single‐chamber and dual‐chamber pacemaker recipients, respectively, where heart failure was the most common cardiac etiology …”

Section: Discussionmentioning

confidence: 99%

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Rehospitalizations for complications and mortality following pacemaker implantation: A retrospective cohort study in an older population

Gillam

Pratt

Inacio

et al. 2018

Clinical Cardiology

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Introduction A large number of older people receive pacemakers each year but broad population‐based studies that describe complications following pacemaker implantation in this population are lacking. Methods We conducted a retrospective cohort study using data from the Australian Government Department of Veterans' Affairs database. The cohort consisted of patients who received a pacemaker from 2005 to 2014. The outcomes were subsequent rehospitalizations for infections, procedure‐related complications, thromboembolism, cardiovascular events (heart failure, myocardial infarction, and atrial fibrillation), and reoperation of pacemaker, and mortality. Results There were 10 883 pacemakers recipients, the median age was 86 years (interquartile range 83‐89), 61% were males, and 74% received a dual‐chamber pacemaker. Within 90 days postdischarge, rehospitalizations were occasioned by pacemaker infection in 0.5%, device‐related complications in 1.5%, cerebral infarction in 0.7%, and heart failure in 6% of single‐chamber pacemaker recipients. In dual‐chamber pacemaker recipients rehospitalizations were occasioned by pacemaker infection in 0.4%, septicemia in 0.4%, device‐related complications in 1.2%, cerebral infarction in 0.3%, and heart failure in 3%. Rehospitalizations for pacemaker adjustment occurred in 1.5% of patients. The 90‐day postdischarge mortality was 5% and 3% in patients with single‐ and dual‐chamber pacemaker, respectively. Conclusion Rehospitalizations for infection, procedure‐related complications, or thromboembolism occurred in 1% to 2% of patients within 90 days postdischarge, while 10% of single chamber and 7% of dual‐chamber recipients experienced a rehospitalization for a cardiovascular event.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rehospitalizations for complications and mortality following pacemaker implantation: A retrospective cohort study in an older population

Gillam

Pratt

Inacio

et al. 2018

Clinical Cardiology

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“…and non-cardiac causes of 30-day readmission. While previous studies have looked at readmissions following CIED implantation, no study has examined the trend and overall causes of these readmissions according to sex and type of CIED [8,[20][21][22]. In a national registry analysis of CIED implantations in Australia and New Zealand, Moore et al reported no 9 difference in hospitalizations for device-related complications between sexes as part of their secondary outcomes (women: 3.4% vs. men: 3.5%, OR 1.05 [0.97, 1.13]) in over 80000 patients [8].…”

mentioning

confidence: 99%

Sex differences in rates and causes of 30-day readmissions after cardiac electronic device implantations: insights from the Nationwide Readmissions Database

Mohamed

Greenspon

Spall

et al. 2020

International Journal of Cardiology

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Background: Women undergoing cardiac implantable electronic device (CIED) implantation are at a higher risk of procedure-related complications. The present study examined sex differences in rates and causes of 30-day readmissions following CIED implantation. Methods: Using the United States Nationwide Readmissions Database (NRD), all adults who had undergone CIED implantation (cardiac resynchronization therapy (CRT), permanent pacemakers (PPM) and implantable cardioverter defibrillators (ICD)) between January 2010 and September 2015 were included. We compared rates, trends and causes of 30-day readmissions between sexes, and examined associations between sex and outcomes (adjusted odds ratios (aOR) and 95% confidence intervals (CI)) Results: Out of 1,155,992 index hospitalizations for CIED implantation, 43.1% of the patients were women. All-cause 30-day readmissions were persistently higher in women than men but declined in both sexes over the study period, more so in women (women vs. men; 2010: 15.0% vs. 14.1%; 2015: 13.7% vs.13.4%). Women were at higher odds of readmission due to cardiac (aOR 1.22, 95%CI 1.20-1.24) and device-related complications (aOR 1.18, 95%CI 1.15-1.20) compared to men, but no difference odds of all-cause readmission were found between sexes (women: aOR 0.998, 95%CI 0.997-1.008). The most common cardiac and non-cardiac causes of readmission were heart failure and infection, respectively, and these were similar in both sexes (men vs. women: 17.8% vs. 17.6% and 10.7% vs. 10.8%, respectively). Conclusion: Women are persistently at higher risk of readmission due to cardiac causes and devicerelated complications compared to men over a six-year period, but no difference in all-cause readmissions was found between sexes.

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“…It is estimated that more than 300,000 CIED devices are implanted each year in the United States . At the same time, historical administrative data suggest that the complication rates of such procedures, specifically CIED infections, are increasing at a disproportionate rate with escalating costs …”

mentioning

confidence: 99%

Antibiotic prophylaxis for cardiac implantable electronic devices: Is the jury out yet?

Shenasa

Krahn²

2019

Pacing Clinical Electrophis

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Thirty-day readmissions after cardiac implantable electronic devices in the United States: Insights from the Nationwide Readmissions Database

Cited by 13 publications

References 27 publications

Rehospitalizations for complications and mortality following pacemaker implantation: A retrospective cohort study in an older population

Rehospitalizations for complications and mortality following pacemaker implantation: A retrospective cohort study in an older population

Sex differences in rates and causes of 30-day readmissions after cardiac electronic device implantations: insights from the Nationwide Readmissions Database

Antibiotic prophylaxis for cardiac implantable electronic devices: Is the jury out yet?

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