Key result
Charlson Comorbidity Index ≥3 linked to higher in-hospital mortality and major complications versus score 0.
Why the study?
Data are limited on how comorbidity burden impacts clinical outcomes in patients undergoing cardiac implantable electronic device (CIED) implantation.
Does a higher comorbidity burden increase adverse outcomes in adults undergoing de novo CIED implantation?
Observational (n=3,103,796)
Yes
Does a higher comorbidity burden increase adverse outcomes in adults undergoing de novo CIED implantation?
Higher comorbidity burden, as measured by the Charlson Comorbidity Index, is a significant predictor of in-hospital mortality and complications following de novo CIED implantation.
Background: There is limited data on the impact of comorbidity burden on clinical outcomes of patients undergoing cardiac implantable electronic devices (CIED) implantation. Objectives: Our aim was to assess trends in CIED implantations and explore the relationship between comorbidity burden and outcomes in patients undergoing de novo implantations. Methods: Using the National Inpatient Sample database from 2000 to 2014, we identified adults ⩾18 years undergoing de novo CIED procedures. Comorbidity burden was assessed by Charlson comorbidity Index (CCI), and patients were classified into 4 categories based on their CCI scores (CCI = 0, CCI = 1, CCI = 2, CCI ⩾3). Annual implantation trends were evaluated. Logistic regression was conducted to measure the association between categorized comorbidity burden and outcomes. Results: A total of 3 103 796 de-novo CIED discharge records were identified from the NIS database. About 22.4% had a CCI score of 0, 28.2% had a CCI score of 1, 22% had a CCI score of 2, and 27.4 % had a CCI score ⩾3. Annual de-novo CIED implantations peaked in 2006 and declined steadily from 2010 to 2014. Compared to CCI 0, CCI ⩾3 was independently associated with increased odds of in-hospital mortality, bleeding, pericardial, and cardiac complications (all P < .05). Length of stay and hospital charges increased with increasing comorbidity burden. Conclusions: CCI is a significant predictor of adverse outcomes after CIED implantation. Therefore, comorbidity burden needs to be considered in the decision-making process for CIED implant candidates.
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Ajibawo et al. (2022) conducted an observational in Cardiac implantable electronic devices (CIED) implantation (n=3,103,796). High comorbidity burden (CCI ≥3) vs. No comorbidity burden (CCI = 0) was evaluated on In-hospital mortality, bleeding, pericardial, and cardiac complications (p=<.05). A Charlson Comorbidity Index score ≥3 was independently associated with increased odds of in-hospital mortality, bleeding, pericardial, and cardiac complications compared to a score of 0 (all P<.05).
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