Hospital readmission after transvenous cardioverter/defibrillator implantation -: A single centre study

被引:26
作者
Korte, T
Jung, W
Ostermann, G
Wolpert, C
Spehl, S
Esmailzadeh, B
Lüderitz, B
机构
[1] Univ Bonn, Dept Cardiol, D-5300 Bonn, Germany
[2] Univ Bonn, Dept Cardiovasc Surg, D-5300 Bonn, Germany
关键词
implantable cardioverter defibrillator; hospital readmission; rehospitalization time;
D O I
10.1053/euhj.1999.2044
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims Hospital readmission after implantation of cardioverter/defibrillators has a major impact on quality of life and cost-effectiveness in defibrillator patients. Rehospitalization has not been studied in large patient populations with modern transvenous defibrillation systems. Methods and Results We report on incidence, reasons, time in follow-up duration and predictors of hospital readmission in 180 patients after transvenous implantation of a cardioverter/defibrillator during a follow-up period of 25 +/- 18 months. There were 156 readmissions in 79 patients with a 0.87 readmission rate per patient during the time followed, a 0.46 readmission rate per patient-year of follow-up and a 0.38 readmission rate per patient-year of follow-up for cardiac reasons. The majority of readmissions was caused by multiple appropriate shock interventions (26%), battery depletion (19%) and lead- and device-related complications (14%). The time to first hospital readmission was 12 +/- 9 months for arrhythmia-related and 20 +/- 16 months for other cardiac-related reasons (P<0.05): and could not be predicted by clinical variables, respectively. The duration of rehospitalization was 14 +/- 15 days for cardiac-related reasons and 12 +/- 17 days far arrhythmia-related reasons. Age >60 years was an independent predictor of rehospitalization time per patient-year of follow-up for both cardiac-related (P<0.005) and arrhythmia-related reasons (P<0.05). Conclusion The rate of hospital readmission per patient-year of follow-up is as high as 0.46 after implantation of a modern cardioverter/defibrillator. Rehospitalization time in such patients is significantly longer in the patient cohort >60 years. The majority of readmissions is caused by multiple appropriate shock treatments. Further studies are needed to systematically investigate strategies for the prevention of rehospitalization in modern ICD therapy. (Eur Heart J 2000; 21: 1186-1191) (C) 2000 The European Society of Cardiology.
引用
收藏
页码:1186 / 1191
页数:6
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