Association between the Charlson comorbidity index and outcomes after implantable cardioverter defibrillator generator replacement

Autor:	Chance M. Witt, Ramila A. Mehta, Nicolette K. Frederick, Jonathan W. Waks, David O. Hodge, Yong Mei Cha, Daniel B. Kramer, Jorge A. Brenes-Salazar, Alfred E. Buxton, Rebecca J. Frey, Mustapha Amin, Paul A. Friedman, Malini Madhavan, Siva K. Mulpuru
Rok vydání:	2019
Předmět:	Male medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Cost of Illness Internal medicine medicine Humans In patient 030212 general & internal medicine Prospective cohort study Aged Retrospective Studies Aged 80 and over Heart Failure Proportional hazards model business.industry Hazard ratio General Medicine Middle Aged Implantable cardioverter-defibrillator medicine.disease Icd therapy Comorbidity Defibrillators Implantable Treatment Outcome Charlson comorbidity index Retreatment Female Cardiology and Cardiovascular Medicine business
Zdroj:	Pacing and Clinical Electrophysiology. 42:1236-1242
ISSN:	1540-8159 0147-8389
DOI:	10.1111/pace.13762
Popis:	BACKGROUND Recipients of implantable cardioverter defibrillator (ICD) generator replacement with multiple medical comorbidities may be at higher risk of adverse outcomes that attenuate the benefit of ICD replacement. The aim of this investigation was to study the association between the Charlson comorbidity index (CCI) and outcomes after ICD generator replacement. METHODS All patients undergoing first ICD generator replacement at Mayo Clinic, Rochester and Beth Israel Deaconess Medical Center, Boston between 2001 and 2011 were identified. Outcomes included: (a) all-cause mortality, (b) appropriate ICD therapy, and (c) death prior to appropriate therapy. Multivariable Cox regression analysis was performed to assess association between CCI and outcomes. RESULTS We identified 1421 patients with mean age of 69.6 ± 12.1 years, 81% male and median (range) CCI of 3 (0-18). During a mean follow-up of 3.9 ± 3 years, 52% of patients died, 30.6% experienced an appropriate therapy, and 23.6% died without experiencing an appropriate therapy. In multivariable analysis, higher CCI score was associated with increased all-cause mortality (Hazard ratio, HR 1.10 [1.06-1.13] per 1 point increase in CCI, P
Databáze:	OpenAIRE
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