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Impact of Comorbidity Burden on Cardiac Implantable Electronic Devices Outcomes

Temitope Ajibawo1, Oluwatimilehin Okunowo2, Adeniyi Okunade3

  • 1Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ, USA.

Clinical Medicine Insights. Cardiology
|July 5, 2022
PubMed

Insights

High comorbidity burden significantly increases risks of mortality and complications after cardiac implantable electronic device (CIED) implantation. Healthcare providers should consider patient comorbidities when deciding on CIED procedures.

Area of Science:

  • Cardiology
  • Health Services Research

Background:

  • Limited data exists on how comorbidity burden affects clinical outcomes in patients receiving cardiac implantable electronic devices (CIEDs).
  • Understanding these impacts is crucial for optimizing patient care and device implantation strategies.

Purpose of the Study:

  • To analyze trends in CIED implantations.
  • To investigate the relationship between comorbidity burden and patient outcomes following de novo CIED implantation.

Main Methods:

  • Utilized the National Inpatient Sample database (2000-2014) for de novo CIED procedures in adults.
  • Assessed comorbidity burden using the Charlson Comorbidity Index (CCI), categorizing patients into four groups (CCI 0, 1, 2, and ≥3).
  • Employed logistic regression to determine the association between comorbidity burden and adverse outcomes.

Main Results:

  • Over 3.1 million de novo CIED discharges were analyzed, with 27.4% of patients having a CCI score of 3 or higher.
  • CIED implantations peaked in 2006 and declined post-2010.
  • Higher CCI scores (≥3) were independently linked to increased in-hospital mortality, bleeding, pericardial, and cardiac complications (P < .05).
  • Increased length of stay and hospital charges correlated with higher comorbidity burden.

Conclusions:

  • The Charlson Comorbidity Index is a significant predictor of adverse outcomes post-CIED implantation.
  • Comorbidity burden must be a key consideration in the clinical decision-making process for potential CIED candidates.
Abstract

Keywords:
Charlson comorbidity indexcardiac implantable electronic devicesoutcomestrends

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