Utilization of Implantable Cardioverter-Defibrillators in Patients With Heart Transplant (from National Inpatient Sample Database).

Autor: Minhas AMK; Division of Medicine, Forrest General Hospital, Hattiesburg, Mississippi., Mahmood Shah SM; Dow University of Health Sciences, Karachi, Pakistan. Electronic address: shah.mustafa010@gmail.com., Shahid I; Ziauddin Medical University, Karachi, Pakistan., Siddiqi TJ; Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi., Arshad MS; Dow University of Health Sciences, Karachi, Pakistan., Jain V; Department of Medicine, Cleveland Clinic Foundation, Cleveland, Ohio., Ullah W; Division of Cardiovascular Medicine, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania., Ahmad MM; Department of Internal Medicine, Merit Health Wesley, Hattiesburg, Mississippi., Bhopalwala HM; Department of Internal Medicine, Appalachian Regional Healthcare, Whitesburg, Kentucky., Dewaswala N; Department of Cardiovascular Disease, University of Kentucky, Lexington, Kentuck., Ijaz SH; Division of Cardiology, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, Massachusetts., Dani SS; Division of Cardiology, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, Massachusetts.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2022 Jul 15; Vol. 175, pp. 65-71. Date of Electronic Publication: 2022 May 18.
DOI: 10.1016/j.amjcard.2022.03.051
Abstrakt: Heart transplant (HT) recipients represent a unique and vulnerable population in whom medium and long-term outcomes are significantly affected by the risk of arrhythmias and sudden cardiac death. The use of implantable cardioverter-defibrillators (ICDs) in this population remains debated. A retrospective analysis of the National Inpatient Sample data between 2009 and 2018 was conducted. Hospitalization data on patients who underwent HT, or who had a preexisting HT, and who received a new ICD were included (excluding the preexisting ICD). Outcomes assessed included inpatient mortality, length of stay, and inflation-adjusted costs. We explored temporal trends in ICD placement and mean length of stay, and predictors of ICD placement. Between 2009 and 2018, 22,673 hospitalizations were recorded for HT, during which patients either received a concurrent new ICD placement (n = 70 [0.31%]) or no new ICD placement (n = 22,603 [99.7%]). During the same period, 146,555 admissions were recorded in patients with a history of HT. ICD placement in patients with a preexisting HT was associated with significantly higher inflation-adjusted costs ($55,680.7 vs $17,219.2; p <0.001). Predictors of ICD placement in preexisting patients with HT included cardiac arrest during hospitalization (odds ratio [OR]:14.3 [3.5 to 58.6]), drug abuse (OR:6.0 [1.3 to 27.1]), and previous PCI (OR:6.0 [2.1 to 17.3]). In conclusion, ICD placement in patients with HT history was associated with significantly higher inflation-adjusted costs. In patients with HT history, factors predicting ICD placement included cardiac arrest at hospitalization, previous PCI, and drug abuse.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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