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Patient and implanting physician factors associated with mortality and complications after implantable cardioverter-defibrillator implantation, 2002-2005.

Publication ,  Journal Article
Al-Khatib, SM; Greiner, MA; Peterson, ED; Hernandez, AF; Schulman, KA; Curtis, LH
Published in: Circ Arrhythm Electrophysiol
October 2008

BACKGROUND: Little is known about factors that influence survival and complications after implantable cardioverter-defibrillator (ICD) implantation in routine clinical practice. We examined patient and implanting physician factors associated with outcomes of ICD therapy in Medicare beneficiaries from 2002 through 2005. METHODS AND RESULTS: We limited this analysis to patients aged >or=65 with Medicare fee-for-service coverage who received an ICD between January 2002 and September 2005. The main outcome measures are time to postprocedural complications within 90 days and 1-year mortality. During the study period, 8581 patients had an ICD implanted by 1959 physicians. The number of procedures increased from 1644 in 2002 to 2374 in the first 3 quarters of 2005. The overall complication rate declined from 18.8% in 2002 to 14.2% in 2005 (P<0.001). Factors independently associated with an increased hazard of complications include chronic lung disease, dementia, renal disease, implantation by a thoracic surgeon, and implantation with removal/replacement. History of congestive heart failure, outpatient implantation, and more recent years of ICD implantation were associated with a lower risk of complications (P<0.05 for all factors). From 2002 to 2005, we observed a decline in 1-year mortality (P<0.001). CONCLUSIONS: We observed an appreciable increase in the number of ICD implants, which was associated with a significant decrease in the rate of complications and 1-year mortality. We identified factors associated with an increased risk of mortality and postprocedural complications that may support more nuanced treatment decisions than are currently possible.

Duke Scholars

Published In

Circ Arrhythm Electrophysiol

DOI

EISSN

1941-3084

Publication Date

October 2008

Volume

1

Issue

4

Start / End Page

240 / 249

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Risk Factors
  • Retrospective Studies
  • Prosthesis Implantation
  • Postoperative Complications
  • Physician's Role
  • Outcome Assessment, Health Care
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Al-Khatib, S. M., Greiner, M. A., Peterson, E. D., Hernandez, A. F., Schulman, K. A., & Curtis, L. H. (2008). Patient and implanting physician factors associated with mortality and complications after implantable cardioverter-defibrillator implantation, 2002-2005. Circ Arrhythm Electrophysiol, 1(4), 240–249. https://doi.org/10.1161/CIRCEP.108.777888
Al-Khatib, Sana M., Melissa A. Greiner, Eric D. Peterson, Adrian F. Hernandez, Kevin A. Schulman, and Lesley H. Curtis. “Patient and implanting physician factors associated with mortality and complications after implantable cardioverter-defibrillator implantation, 2002-2005.Circ Arrhythm Electrophysiol 1, no. 4 (October 2008): 240–49. https://doi.org/10.1161/CIRCEP.108.777888.
Al-Khatib SM, Greiner MA, Peterson ED, Hernandez AF, Schulman KA, Curtis LH. Patient and implanting physician factors associated with mortality and complications after implantable cardioverter-defibrillator implantation, 2002-2005. Circ Arrhythm Electrophysiol. 2008 Oct;1(4):240–9.
Al-Khatib, Sana M., et al. “Patient and implanting physician factors associated with mortality and complications after implantable cardioverter-defibrillator implantation, 2002-2005.Circ Arrhythm Electrophysiol, vol. 1, no. 4, Oct. 2008, pp. 240–49. Pubmed, doi:10.1161/CIRCEP.108.777888.
Al-Khatib SM, Greiner MA, Peterson ED, Hernandez AF, Schulman KA, Curtis LH. Patient and implanting physician factors associated with mortality and complications after implantable cardioverter-defibrillator implantation, 2002-2005. Circ Arrhythm Electrophysiol. 2008 Oct;1(4):240–249.

Published In

Circ Arrhythm Electrophysiol

DOI

EISSN

1941-3084

Publication Date

October 2008

Volume

1

Issue

4

Start / End Page

240 / 249

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Risk Factors
  • Retrospective Studies
  • Prosthesis Implantation
  • Postoperative Complications
  • Physician's Role
  • Outcome Assessment, Health Care
  • Male