Abstract
Background: The utilization of cardiac resynchronization therapy defibrillator (CRT-D) has increased significantly, since its initial approval for use in selected patients with heart failure. Limited data exist as for current trends in implant-related in-hospital complications and cost utilization. The aim of our study was to examine in-hospital complication rates associated with CRT-D and their trends over the last decade. Methods and Results: Using the Nationwide Inpatient Sample, we estimated 378 248 CRT-D procedures from 2003 to 2012. We investigated common complications, including mechanical, cardiovascular, pericardial complications (hemopericardium, cardiac tamponade, or pericardiocentesis), pneumothorax, stroke, vascular complications (consisting of hemorrhage/hematoma, incidents requiring surgical repair, and accidental arterial puncture), and in-hospital deaths described with CRT-D, defining them by the validated International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code. Mechanical complications (5.9%) were the commonest, followed by cardiovascular (3.6%), respiratory failure (2.4%), and pneumothorax (1.5%). Age (≥65 years), female gender (OR, 95% CI; P value) (1.08, 1.03-1.13; 0.001), and the Charlson score ≥3 (1.52, 1.45-1.60; <0.001) were significantly associated with increased mortality/complications. Conclusions: The overall complication rate in patients undergoing CRT-D has been increasing in the last decade. Age (≥65), female sex, and the Charlson score ≥3 were associated with higher complications. In patients who underwent CRT-D implantation, postoperative complications were associated with significant increases in cost.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1425-1435 |
| Number of pages | 11 |
| Journal | Journal of Cardiovascular Electrophysiology |
| Volume | 29 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 1 2018 |
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Keywords
- cardiac resynchronization therapy defibrillator
- complications
- cost
- mortality
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)
Cite this
Frequency of in-hospital adverse outcomes and cost utilization associated with cardiac resynchronization therapy defibrillator implantation in the United States. / Patel, Nilay; Viles-Gonzalez, Juan; Agnihotri, Kanishk; Arora, Shilpkumar; Patel, Nileshkumar J.; Aneja, Ekta; Shah, Mahek; Badheka, Apurva O.; Pothineni, Naga Venkata; Kancharla, Krishna; Mulpuru, Siva; Noseworthy, Peter; Kusumoto, Fred; Cha, Yong-Mei; Deshmukh, Abhishek J.
In: Journal of Cardiovascular Electrophysiology, Vol. 29, No. 10, 01.10.2018, p. 1425-1435.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Frequency of in-hospital adverse outcomes and cost utilization associated with cardiac resynchronization therapy defibrillator implantation in the United States
AU - Patel, Nilay
AU - Viles-Gonzalez, Juan
AU - Agnihotri, Kanishk
AU - Arora, Shilpkumar
AU - Patel, Nileshkumar J.
AU - Aneja, Ekta
AU - Shah, Mahek
AU - Badheka, Apurva O.
AU - Pothineni, Naga Venkata
AU - Kancharla, Krishna
AU - Mulpuru, Siva
AU - Noseworthy, Peter
AU - Kusumoto, Fred
AU - Cha, Yong-Mei
AU - Deshmukh, Abhishek J.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Background: The utilization of cardiac resynchronization therapy defibrillator (CRT-D) has increased significantly, since its initial approval for use in selected patients with heart failure. Limited data exist as for current trends in implant-related in-hospital complications and cost utilization. The aim of our study was to examine in-hospital complication rates associated with CRT-D and their trends over the last decade. Methods and Results: Using the Nationwide Inpatient Sample, we estimated 378 248 CRT-D procedures from 2003 to 2012. We investigated common complications, including mechanical, cardiovascular, pericardial complications (hemopericardium, cardiac tamponade, or pericardiocentesis), pneumothorax, stroke, vascular complications (consisting of hemorrhage/hematoma, incidents requiring surgical repair, and accidental arterial puncture), and in-hospital deaths described with CRT-D, defining them by the validated International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code. Mechanical complications (5.9%) were the commonest, followed by cardiovascular (3.6%), respiratory failure (2.4%), and pneumothorax (1.5%). Age (≥65 years), female gender (OR, 95% CI; P value) (1.08, 1.03-1.13; 0.001), and the Charlson score ≥3 (1.52, 1.45-1.60; <0.001) were significantly associated with increased mortality/complications. Conclusions: The overall complication rate in patients undergoing CRT-D has been increasing in the last decade. Age (≥65), female sex, and the Charlson score ≥3 were associated with higher complications. In patients who underwent CRT-D implantation, postoperative complications were associated with significant increases in cost.
AB - Background: The utilization of cardiac resynchronization therapy defibrillator (CRT-D) has increased significantly, since its initial approval for use in selected patients with heart failure. Limited data exist as for current trends in implant-related in-hospital complications and cost utilization. The aim of our study was to examine in-hospital complication rates associated with CRT-D and their trends over the last decade. Methods and Results: Using the Nationwide Inpatient Sample, we estimated 378 248 CRT-D procedures from 2003 to 2012. We investigated common complications, including mechanical, cardiovascular, pericardial complications (hemopericardium, cardiac tamponade, or pericardiocentesis), pneumothorax, stroke, vascular complications (consisting of hemorrhage/hematoma, incidents requiring surgical repair, and accidental arterial puncture), and in-hospital deaths described with CRT-D, defining them by the validated International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code. Mechanical complications (5.9%) were the commonest, followed by cardiovascular (3.6%), respiratory failure (2.4%), and pneumothorax (1.5%). Age (≥65 years), female gender (OR, 95% CI; P value) (1.08, 1.03-1.13; 0.001), and the Charlson score ≥3 (1.52, 1.45-1.60; <0.001) were significantly associated with increased mortality/complications. Conclusions: The overall complication rate in patients undergoing CRT-D has been increasing in the last decade. Age (≥65), female sex, and the Charlson score ≥3 were associated with higher complications. In patients who underwent CRT-D implantation, postoperative complications were associated with significant increases in cost.
KW - cardiac resynchronization therapy defibrillator
KW - complications
KW - cost
KW - mortality
UR - http://www.scopus.com/inward/record.url?scp=85055180164&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055180164&partnerID=8YFLogxK
U2 - 10.1111/jce.13701
DO - 10.1111/jce.13701
M3 - Article
C2 - 30016005
AN - SCOPUS:85055180164
VL - 29
SP - 1425
EP - 1435
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
SN - 1045-3873
IS - 10
ER -