Document Detail


Hospital readmission in patients with implantable cardioverter-defibrillators.
MedLine Citation:
PMID:  16886125     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Hospital readmissions are one of the important problems of patients with implantable cardioverter-defibrillators (ICD). Detailed analysis of the causes of re-hospitalizations may lead to improved management of ICD patients and eventually limit the number of hospital readmissions. AIM: Prospective analysis of repeat hospitalisations, their causes and time from discharge to first hospital readmission in a group of patients after ICD implantation. A search for predictors of rehospitalisation was also performed. METHODS: Analysis involved 133 consecutive patients who underwent ICD implantation in the Department of Cardiology, PAM. Readmission causes were split into cardiac and non-cardiac. An index of repeat hospitalisation was calculated and parameters with a direct impact on rehospitalisation necessity were also evaluated. RESULTS: One hundred and sixty-seven hospital readmissions of 72 (54%) patients were noted at mean 22+/-15 months after the primary hospitalisation. Rehospitalisation index per patient for the total follow-up period was 1.26, while for the first year of follow-up it was 0.69. In the case of 42 (32%) patients, 91 (54.5%) hospital readmissions were associated with arrhythmia. In 34 (25.6%) patients, 54 (32.3%) re-hospitalizations were not related to arrhythmia, while 20 (15%) patients were hospitalised 22 times (13.2%) for non-cardiac reasons. Mean time to the first readmission, regardless of the reason, was 9+/-9 months. Predominant causes of repeat hospitalisation were ventricular arrhythmias and worsening of heart failure. Patients with left ventricular ejection fraction (LVEF) below 30% and in functional NYHA class III were readmitted to hospital more frequently for reasons not related to arrhythmia. CONCLUSIONS: Hospital readmissions for cardiac causes in patients after ICD implantation are still frequent. Most of them are caused by ventricular arrhythmia and heart failure. Low LVEF (<30%) and NYHA functional class > or =III are risk factors predicting repeat hospitalisations unrelated to arrhythmia.
Authors:
Jarosław Kaźmierczak; Joanna Zielonka; Ryszard Rzeuski; Małgorzata Peregud-Pogorzelska; Jarosław Goracy; Jowita Biernawska; Tadeusz Sulikowski; Zdzisława Kornacewicz-Jach
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kardiologia polska     Volume:  64     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-08-03     Completed Date:  2007-01-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  684-91; discussion 692-3     Citation Subset:  IM    
Affiliation:
Klinika Kardiologii, Pomorska Akademia Medyczna, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland. j.kazmierczak@acx.pl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arrhythmias, Cardiac / therapy*
Defibrillators, Implantable / statistics & numerical data*
Electric Countershock / instrumentation*
Equipment Failure / statistics & numerical data
Female
Follow-Up Studies
Hospitalization
Humans
Male
Middle Aged
Patient Readmission / statistics & numerical data*
Poland
Prognosis
Prospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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