Key result
Patients receiving tiered-therapy implantable defibrillators experienced a cardiac-related hospital readmission rate of 0.72 per patient-year, which could not be predicted by clinical parameters.
Cohort (n=65)
No
Cardiac-related hospital readmissions are frequent and costly in patients with tiered-therapy implantable defibrillators, and are associated with poor preimplant NYHA functional class.
Answers are grounded in this paper and cite their sources.
Frequent cardiac readmissions after tiered-therapy ICDs raise costs and impair quality of life; leaves open better risk stratification and prevention strategies.
BACKGROUND: We wished to determine the incidence, reasons, costs, and predictors of cardiac-related hospital readmission in patients with tiered-therapy implantable defibrillators. Hospital readmission in patients with defibrillators reduces their quality of life and increases the cost associated with such therapy. METHODS AND RESULTS: We retrospectively studied 65 consecutive local patients (median age, 67 years; median ejection fraction, 0.34) who underwent tiered-therapy defibrillator implantation at this institution. Patients were followed for a median of 19 months (interquartile range, 10 to 27 months). The cause, duration, costs, and predictors of cardiac-related rehospitalizations were analyzed. There were 76 cardiac admissions for 34 patients. The rate of cardiac-related hospital readmission was 0.72 per patient-year of follow-up. Arrhythmia-related admissions accounted for 43 of such admissions in 24 patients. Actuarial freedom from cardiac-related admissions was 0.57 and 0.40 at 1 and 2 years, respectively. The median length of stay for hospital readmissions was 5 days (interquartile range, 3 to 8 days). The median cost per admission was $5842 (interquartile range, $3549 to $12 170). The time to first readmission and the total rehospitalization time per year of follow-up were associated with a poor preimplant New York Heart Association functional class. Readmission for cardiac arrhythmias was not predicted by clinical parameters. CONCLUSIONS: Rehospitalization for cardiac reasons is common in patients receiving implantable defibrillators and is responsible for substantial resource consumption. The need for readmission for arrhythmia-related reasons cannot be predicted by clinical parameters at the time of device implantation.
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Fahy et al. (1996) conducted a cohort in Tiered-therapy implantable defibrillators (n=65). Tiered-therapy implantable defibrillators was evaluated on Incidence of cardiac-related hospital readmission. Patients receiving tiered-therapy implantable defibrillators experienced a cardiac-related hospital readmission rate of 0.72 per patient-year, which could not be predicted by clinical parameters.
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