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).
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.
p-value: p=<.05
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.
Ajibawo et al. (Sat,) conducted a 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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