In-hospital mortality of patients with atrial arrhythmias: insights from the German-wide Helios hospital network of 161 502 patients and 34 025 arrhythmia-related procedures.

Autor:	König S; Department of Electrophysiology, Heart Center Leipzig - Universital Hospital, Strümpellstraße 39, 04289 Leipzig, Germany.; Leipzig Heart Institute, Russenstraße 69a, 04289 Leipzig, Germany., Ueberham L; Department of Electrophysiology, Heart Center Leipzig - Universital Hospital, Strümpellstraße 39, 04289 Leipzig, Germany.; Leipzig Heart Institute, Russenstraße 69a, 04289 Leipzig, Germany., Schuler E; Helios Kliniken GmbH, Friedrichstraße 136, 10117 Berlin, Germany., Wiedemann M; Department of Cardiology, Helios Hospital Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany., Reithmann C; Department of Internal Medicine I, Helios Hospital München West, Steinerweg 5, 81241 München, Germany., Seyfarth M; Department of Cardiology, Helios University Hospital Wuppertal, Heusnerstraße 40, 42283 Wuppertal, Germany., Sause A; Department of Cardiology, Helios University Hospital Wuppertal, Heusnerstraße 40, 42283 Wuppertal, Germany., Tebbenjohanns J; Department of Cardiology, Helios Hospital Hildesheim, Senator-Braun-Allee 33, 31135 Hildesheim, Germany., Schade A; Department of Cardiology, Helios Hospital Erfurt, Nordhäuser Straße 74, 99089 Erfurt, Germany., Shin DI; Department of Cardiology, Helios Hospital Krefeld, Lutherplatz 40, 47805 Krefeld, Germany., Staudt A; Department of Cardiology and Angiology, Helios Hospital Schwerin, Wismarische Straße 393-397, 19053 Schwerin, Germany., Zacharzowsky U; Department of Cardiology, Helios Hospital Bad Saarow, Pieskower Straße 33, 15526 Bad Saarow, Germany., Andrié R; Department of Cardiology, Helios Hospital Siegburg, Ringstraße 49, 53721 Siegburg, Germany., Wetzel U; Department of Cardiology, Helios Hospital Aue, Gartenstraße 6, 08280 Aue, Germany., Neuser H; Department of Internal Medicine II, Helios Hospital Plauen, Röntgenstraße 2, 08529 Plauen, Germany., Wunderlich C; Department of Internal Medicine II, Helios Hospital Pirna, Struppener Straße 13, 01796 Pirna, Germany., Kuhlen R; Leipzig Heart Institute, Russenstraße 69a, 04289 Leipzig, Germany.; Helios Kliniken GmbH, Friedrichstraße 136, 10117 Berlin, Germany., Tijssen JGP; Academic Medical Center - University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands., Hindricks G; Department of Electrophysiology, Heart Center Leipzig - Universital Hospital, Strümpellstraße 39, 04289 Leipzig, Germany.; Leipzig Heart Institute, Russenstraße 69a, 04289 Leipzig, Germany., Bollmann A; Department of Electrophysiology, Heart Center Leipzig - Universital Hospital, Strümpellstraße 39, 04289 Leipzig, Germany.; Leipzig Heart Institute, Russenstraße 69a, 04289 Leipzig, Germany.
Jazyk:	angličtina
Zdroj:	European heart journal [Eur Heart J] 2018 Nov 21; Vol. 39 (44), pp. 3947-3957.
DOI:	10.1093/eurheartj/ehy528
Abstrakt:	Aims: Atrial fibrillation (AFib) and atrial flutter (AFlut) are common arrhythmias with increased use of invasive procedures. A steady re-evaluation of relevant safety endpoints is recommended and both quality management and pay-for-performance programs are evolving. Therefore, the aims of this study were (i) to investigate and report overall in-hospital mortality and mortality of invasive arrhythmia-related procedures and (ii) to identify mortality predictors in a German-wide hospital network. Methods and Results: Administrative data provided by 78 Helios hospitals between 2010 and 2017 were examined using International Statistical Classification of Diseases and Related Health Problems- and Operations and Procedures-codes to identify patients with AFib or AFlut as main discharge diagnosis or secondary diagnosis combined with invasive arrhythmia-related interventions. In 161 502 patients, in-hospital mortality was 0.6% with a significant decrease from 0.75% to 0.5% (P < 0.01) during the observational period. In multivariable analysis, age [odds ratio (OR) 2.69, 95% confidence interval (CI) 2.36-3.05; P < 0.01], high centre volume (OR 0.57, 95% CI 0.50-0.65; P < 0.01), emergency hospital admission (OR 1.57, 95% CI 1.38-1.79; P < 0.01), and Charlson Comorbidity Index (CCI, OR 4.95, 95% CI 4.50-5.44; P < 0.01) were found as independent predictors of in-hospital mortality. Mortality rates were 0.05% for left atrial catheter ablation (CA, n = 21 744), 0.3% for right atrial CA (n = 9972), and 0.56% for implantation of a left atrial appendage occluder (n = 2309), respectively. Conclusion: We analysed for the first time in-hospital mortality rates of patients with atrial arrhythmias in a German-wide, multi-centre administrative dataset. This allows feasible, comparable, and up-to-date performance measurement of clinically important endpoints in a real-world setting which may contribute to quality management programs and towards value-based healthcare.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu