Predictors of outcomes in hospitalized patients undergoing pacemaker insertion: Analysis from the national inpatient database (2016‐2017)

Abstract

Background Pacemaker implantation in the U.S. is rising due to an aging population. The aim of this analysis was to identify risk factors associated with increased mortality and complications in hospitalized patients requiring pacemaker implantation. Methods We performed a retrospective analysis using the National Inpatient Sample database, identifying hospitalized patients who underwent pacemaker implantation using International Classification of Disease, Tenth Revision, Clinical Modification codes. Independent predictors of inpatient mortality were identified using multivariate logistic regression analysis. Results There were 242,980 hospitalizations with pacemaker implantation during 2016 and 2017. The most frequently encountered indications for hospitalizations involving pacemaker insertion included sick sinus syndrome (SSS) (27.60%), complete atrioventricular (AV) block (21.57%), and second‐degree AV block (7.83%). Chronic liver disease was associated with the highest adjusted odds of inpatient mortality (aOR = 5.76, 95% CI: 4.46 to 7.44, p < .001). Comorbid anemia had the highest statistically significant adjusted odds ratio (aOR) for predictors of post‐procedural cardiac complications (aOR = 3.17, 95% CI: 2.81 to 3.58, p < .001). Mortality in hospitalized patients needing pacemaker implantation was 1.05%. About 3.36% of hospitalizations developed post procedural circulatory complications (PPCC), 2.45% developed sepsis, and 1.84% developed mechanical complications of cardiac electronic devices. Conclusions We identified several predictors of inpatient mortality in hospitalized patients undergoing pacemaker implantation, including chronic liver disease, protein‐calorie malnutrition, chronic heart failure, anemia, and history of malignancy. Anemia, chronic liver disease, and congestive heart failure were independent predictors of adverse outcomes in such patients.

Nutritional Status Predicts the Length of Stay and Mortality in Patients Undergoing Electrotherapy Procedures

“…The present study showed that malnutrition impacts in-hospital mortality after CIED implantations. The analysis by Kichloo et al confirmed our observations, as it indicated that malnutrition is one of the mortality predictors in hospitalizations involving pacemaker implantation [35]. Our study showed that a higher NRS 2002 score is associated with higher mortality among CIED-implanted patients.…”

“…There is published evidence for the role of malnutrition in long-term mortality after selected electrotherapy procedures, i.e., pacemakers, implantable cardioverter-defibrillator (ICD), or cardiac resynchronization therapy (CRT) implantations [ 32 , 33 , 34 ]. There is only one published study that showed a higher in-hospital mortality of malnourished patients undergoing pacemaker implantations [ 35 ]. There are no available publications that focus on in-hospital mortality after other types of CIED implantations.…”

Fatores Associados aos Custos do Tratamento no Primeiro Ano após Implantes Iniciais ou Trocas de Geradores de Pulsos de Marca-passos Cardíacos

“… 1 - 3 Estudos embasados em análise de dados de sistemas administrativos, entretanto, têm demonstrado aumento progressivo das taxas de complicações pós-operatórias e de readmissões hospitalares, que têm sido explicados, principalmente, pela fragilidade e pelas comorbidades desta população. 4 - 8 …”

“… 1 - 3 However, studies based on data analysis from administrative systems have demonstrated a progressive increase in the rates of postoperative complications and hospital readmissions, which have been mainly explained by the frailty and comorbidities of this population. 4 - 8 …”