Hospital utilisation and the costs associated with complications of ICD implantation in a contemporary primary prevention cohort.

Autor: van Barreveld M; Department of Cardiology, Heart Centre, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. m.vanbarreveld@amsterdamumc.nl.; Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. m.vanbarreveld@amsterdamumc.nl., Verstraelen TE; Department of Cardiology, Heart Centre, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Buskens E; Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands., van Dessel PFHM; Department of Cardiology, Thorax centre Twente, Medisch Spectrum Twente, Enschede, The Netherlands., Boersma LVA; Cardiology Department, St. Antonius Ziekenhuis, Nieuwegein, The Netherlands., Delnoy PPHM; Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands., Tuinenburg AE; Department of Cardiology, Division of Heart and Lungs, University Medical Centre, Utrecht, The Netherlands., Theuns DAMJ; Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands., van der Voort PH; Department of Cardiology, Catharina Ziekenhuis Eindhoven, Eindhoven, The Netherlands., Kimman GP; Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands., Zwinderman AH; Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Wilde AAM; Department of Cardiology, Heart Centre, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Dijkgraaf MGW; Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation [Neth Heart J] 2023 Jun; Vol. 31 (6), pp. 244-253. Date of Electronic Publication: 2022 Nov 24.
DOI: 10.1007/s12471-022-01733-4
Abstrakt: Introduction: Implantation of an implantable cardioverter defibrillator (ICD) is standard care for primary prevention of sudden cardiac death. However, ICD-related complications are increasing as the population of ICD recipients grows.
Methods: ICD-related complications in a national DO-IT Registry cohort of 1442 primary prevention ICD patients were assessed in terms of additional use of hospital care resources and costs.
Results: During a median follow-up of 28.7 months (IQR 25.2-33.7) one or more complications occurred in 13.5% of patients. A complication resulted in a surgical intervention in 53% of cases and required on average 3.65 additional hospital days. The additional hospital costs were €6,876 per complication or €8,110 per patient, to which clinical re-interventions and additional hospital days contributed most. Per category of complications, infections required most hospital utilisation and were most expensive at an average of €22,892. The mean costs were €5,800 for lead-related complications, €2,291 for pocket-related complications and €5,619 for complications due to other causes. We estimate that the total yearly incidence-based costs in the Netherlands for hospital management of ICD-related complications following ICD implantation for primary prevention are €2.7 million.
Conclusion: Complications following ICD implantation are related to a substantial additional need for hospital resources. When performing cost-effectiveness analyses of ICD implantation, including the costs associated with complications, one should be aware that real-world complication rates may deviate from trial data. Considering the economic implications, strategies to reduce the incidence of complications are encouraged.
(© 2022. The Author(s).)
Databáze: MEDLINE
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