September 15, 1996Annals of Internal Medicine
Survival and Functional Independence after Implantation of a Permanent Pacemaker in Octogenarians and Nonagenarians: A Population-Based Study
Why the study?
Does implantation of a permanent pacemaker affect survival and functional independence in octogenarians and nonagenarians?
Population
157 octogenarians and nonagenarians who initially received a permanent pacemaker between 1962 and 1988
Comparison
Implantation of a permanent pacemaker vs Age- and sex-matched controls
Design
Cohort
Follow-up
Followed through 1992 (implanted between 1962 and 1988)
Authors
Discussion
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Implication
Pacemaker recipients without heart disease had survival similar to controls; leaves open effects on functional independence in octogenarians.
Key Points
- Evaluate long-term survival and functional independence after permanent pacemaker implantation in octogenarians and nonagenarians.
- Retrospective, population-based cohort study involving 157 patients aged 80 and older.
- Patients received pacemakers between 1962 and 1988 and were followed through 1992.
- Main outcome measures included overall mortality rate, functional capabilities, and nursing home placement.
- Observed survival in patients with heart disease was significantly worse than in matched controls (P < 0.001).
- 75% of patients experienced a decrease in symptoms after pacemaker implantation.
- 32% of patients developed or worsened dementia post-implantation.
Structured PICO
Does implantation of a permanent pacemaker affect survival and functional independence in octogenarians and nonagenarians?
P
Population
157 octogenarians and nonagenarians who initially received a permanent pacemaker between 1962 and 1988
I
Intervention
Implantation of a permanent pacemaker
C
Comparator
Age- and sex-matched controls
O
Outcome
Overall mortality rate, functional capabilities, and placement in a nursing homehard clinical
Permanent pacemaker implantation in octogenarians and nonagenarians alleviates symptoms and is associated with normal relative survival in those without underlying heart disease, though nursing home placement and disabilities remain common.
Cite This Study
Shen et al. (1996) studied this question.