Occurrence, mortality and predictors of complicated cardiac perforation in patients with CRT-D: Based on the National Inpatient Sample registry
| Autor: | Hiro Kawata, Shaista Malik, Taishi Hirai, Ola Lafi, Ching Wei Chen, Ashwini Erande, Peter Santucci |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis Adolescent Databases Factual medicine.medical_treatment Cardiac resynchronization therapy Cardiomyopathy 030204 cardiovascular system & hematology Cardiac Resynchronization Therapy 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications Interquartile range Predictive Value of Tests Cardiac Perforation Cardiac tamponade medicine Humans 030212 general & internal medicine Cardiac Resynchronization Therapy Devices Registries Mortality Coronary sinus Aged Aged 80 and over business.industry Middle Aged medicine.disease Implantable cardioverter-defibrillator United States Surgery Heart Injuries cardiovascular system Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | International journal of cardiology. 293 |
| ISSN: | 1874-1754 |
| Popis: | Background Cardiac Resynchronization Therapy Defibrillator (CRT-D) has been one of the most important therapies for patients with cardiomyopathy over the last decades. Cardiac perforation occurs infrequently but can be fatal. The occurrence of cardiac perforation after CRT-D implantation has not been studied well. The aim of study is to investigate the occurrence, mortality and predictors of cardiac perforation in patients receiving CRT-D during the index hospitalization. Methods Data were obtained from the National Inpatient Sample, the largest all-player inpatient dataset in the United States. Patients who received CRT-D from 2002 to 2012 were identified using ICD-9 codes. Multivariate analyses were used to identify predictors of cardiac perforation. Complications including in-hospital death and cardiac perforation were identified using ICD-9 codes. Results A total of 77,827 patients with CRT-D implantation were included into our analysis. After the CRT-D implantation, the in-hospital and rate of cardiac perforation was between 0.24 and 0.48% and had increased significantly (p = 0.02). Although occurrence of cardiac perforation is rare (0.32%), the mortality was 10.6% among those patients with cardiac perforation. In Multivariate analysis identified female as independent risk factors for cardiac perforation (OR: 2.628, 95% CI 1.926–3.585, p Conclusion Despite rapid progress of the tools and skills for CRT-D implantation, the occurrence of cardiac perforation has not improved. While cardiac perforation is rare, it carries the highest rate of mortality, especially in female patients. Implanting physicians should be familiar with the comorbidities and patient demographics that put them at a higher risk for complications. |
| Databáze: | OpenAIRE |
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