Key result
The incidence of hospital readmissions within one year was 16.4% after initial pacemaker implantation and 10.6% after generator replacement, with readmissions significantly increasing total annual treatment costs.
Why the study?
With the growing use of pacemakers, the rates of readmissions and complications after implantation or generator replacement and their impact on annual treatment costs needed to be determined.
What are the rates of hospital readmissions and complications after pacemaker implantation or pulse generator replacement, and what factors are associated with annual treatment costs?
Cohort (n=1,223)
No
What are the rates of hospital readmissions and complications after pacemaker implantation or pulse generator replacement, and what factors are associated with annual treatment costs?
Absolute Event Rate: 16.4% vs 10.6%
Age, comorbidities, postoperative complications, and hospital readmissions are significantly associated with increased total annual treatment costs for patients with pacemakers in the Brazilian public health system.
Readmissions drive higher costs after initial implantation; leaves open whether targeted strategies reduce them in prospective studies.
Background The use of artificial cardiac pacemakers has grown steadily in line with the aging population. Objectives To determine the rates of hospital readmissions and complications after pacemaker implantation or pulse generator replacement and to assess the impact of these events on annual treatment costs from the perspective of the Unified Health System (SUS). Methods A prospective registry, with data derived from clinical practice, collected during index hospitalization and during the first 12 months after the surgical procedure. The cost of index hospitalization, the procedure, and clinical follow-up were estimated according to the values reimbursed by SUS and analyzed at the patient level. Generalized linear models were used to study factors associated with the total annual treatment cost, adopting a significance level of 5%. Results A total of 1,223 consecutive patients underwent initial implantation (n=634) or pulse generator replacement (n=589). Seventy episodes of complication were observed in 63 patients (5.1%). The incidence of hospital readmissions within one year was 16.4% (95% CI 13.7% - 19.6%) after initial implants and 10.6% (95% CI 8.3% - 13.4%) after generator replacements. Chronic kidney disease, history of stroke, length of hospital stays, need for postoperative intensive care, complications, and hospital readmissions showed a significant impact on the total annual treatment cost. Conclusions The results confirm the influence of age, comorbidities, postoperative complications, and hospital readmissions as factors associated with increased total annual treatment cost for patients with pacemakers.
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Alves et al. (2024) conducted a cohort in Pacemaker implantation or pulse generator replacement (n=1,223). Initial pacemaker implantation vs. Pulse generator replacement was evaluated on Hospital readmissions within one year. The incidence of hospital readmissions within one year was 16.4% after initial pacemaker implantation and 10.6% after generator replacement, with readmissions significantly increasing total annual treatment costs.
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