What is the clinical evidence from this study?

Study design: Cohort. Population: Heart failure (n=26887). Intervention: Advanced age (≥80 years) vs. Age <80 years. Primary outcome: In-hospital mortality (p=<.001).

What question did this study set out to answer?

This research aimed to characterize the use and outcomes of implantable cardiac devices in older heart failure patients.

April 12, 2010Archives of Internal Medicine

Implantable Cardiac Device Procedures in Older Patients

Q: What are the key findings of this study?

Advanced age independently predicted in-hospital mortality following device implantation, rising from 0.7% in patients 85 years (P<0.001).

Q: What question did this study set out to answer?

This research aimed to characterize the use and outcomes of implantable cardiac devices in older heart failure patients.

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Key result

Advanced age independently predicted in-hospital mortality following device implantation, rising from 0.7% in patients <80 years to 2.2% in those >85 years (P<0.001).

Why the study?

Does advanced age increase the risk of in-hospital mortality in heart failure patients undergoing ICD or CRT implantation?

Key Points

This research aimed to characterize the use and outcomes of implantable cardiac devices in older heart failure patients.
Analyzed data from patients older than 18 with heart failure undergoing ICD or CRT implantation from 2004-2005.
Data collected included demographics, comorbidities, device type, complications, and hospitalization costs.
Utilized multivariate logistic regression to identify risk factors for in-hospital mortality.
Identified 26,887 patients with a median age of 70, with increased mortality in patients aged 80+ years (1.2% to 2.2%, P < .001).
Older patients more likely to receive CRT alone compared to younger counterparts.
Independent mortality predictors included age ≥80, elevated comorbidity score, inotrope use, and complications from procedures.

Study Design

Type

Cohort (n=26,887)

Multicenter

Yes

Structured PICO

Does advanced age increase the risk of in-hospital mortality in heart failure patients undergoing ICD or CRT implantation?

Population

26,887 patients older than 18 years with heart failure undergoing ICD or CRT implantation, assessed for in-hospital mortality.

Exposure

Implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT) implantation in older patients (≥80 years)

Comparator

Younger patients (<80 years) undergoing the same procedures

Outcome

In-hospital mortalityhard clinical

Main Result

p-value: p=<.001

Advanced age (≥80 years) is an independent predictor of in-hospital mortality following ICD or CRT implantation in heart failure patients, highlighting the need for careful patient selection in this demographic.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Observational data on age-specific ICD/CRT use and outcomes in HF; leaves open optimal patient selection pending prospective trials.

Cite This Study

Swindle et al. (2010) conducted a cohort in Heart failure (n=26,887). Advanced age (≥80 years) vs. Age <80 years was evaluated on In-hospital mortality (p=<.001). Advanced age independently predicted in-hospital mortality following device implantation, rising from 0.7% in patients <80 years to 2.2% in those >85 years (P<0.001).

synapsesocial.com/papers/6a6ca614ac440176ef26c571 https://doi.org/10.1001/archinternmed.2010.30

Topics

Cardiac device therapy Heart failure HFrEF treatment

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Implantable Cardiac Device Procedures in Older Patients

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Topics

Implantable Cardiac Device Procedures in Older Patients

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider