Copyright © 2000 by the European Society of Cardiology.
Hospital readmission after transvenous cardioverter/defibrillator implantation. A single centre study
a Departments of Cardiology, University of Bonn, Bonn, Germany
b Cardiovascular Surgery, University of Bonn, Bonn, Germany
revised November 22, 1999; accepted November 24, 1999
Abstract
Aims Hospital readmission after implantation of cardioverter/defibrillators has a major impact on quality of life and cost-effectiveness in defibrillator patients. Rehospitalization has not been studied in large patient populations with modern transvenous defibrillation systems.
Methods and Results We report on incidence, reasons, time in follow-up, duration and predictors of hospital readmission in 180 patients after transvenous implantation of a cardioverter/defibrillator during a follow-up period of 25±18 months. There were 156 readmissions in 79 patients with a 0·87 readmission rate per patient during the time followed, a 0·46 readmission rate per patient-year of follow-up and a 0·38 readmission rate per patient-year of follow-up for cardiac reasons. The majority of readmissions was caused by multiple appropriate shock interventions (26%), battery depletion (19%) and lead- and device-related complications (14%). The time to first hospital readmission was 12±9 months for arrhythmia-related and 20±16 months for other cardiac-related reasons (P<0·05), and could not be predicted by clinical variables, respectively. The duration of rehospitalization was 14±15 days for cardiac-related reasons and 12±17 days for arrhythmia-related reasons. Age >60 years was an independent predictor of rehospitalization time per patient-year of follow-up for both cardiac-related (P<0·005) and arrhythmia-related reasons (P<0·05).
Conclusion The rate of hospital readmission per patient-year of follow-up is as high as 0·46 after implantation of a modern cardioverter/defibrillator. Rehospitalization time in such patients is significantly longer in the patient cohort >60 years. The majority of readmissions is caused by multiple appropriate shock treatments. Further studies are needed to systematically investigate strategies for the prevention of rehospitalization in modern ICD therapy.
Key Words: Implantable cardioverter defibrillator, hospital readmission, rehospitalization time
f1 Correspondence: Thomas Korte, MD, Dept. of Cardiology, Medical School Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
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