Document Detail


Implantable cardioverter-defibrillator registry risk score models for acute procedural complications or death after implantable cardioverter-defibrillator implantation.
MedLine Citation:
PMID:  21537001     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients undergoing implantable cardioverter-defibrillator (ICD) implantation are at risk of postprocedural complications. However, we do not have a risk stratification schema to identify patients at high and low risk of adverse events.
METHODS AND RESULTS: We analyzed data from 268 701 ICD implants submitted to the ICD Registry and developed logistic regression models to identify variables most strongly associated with the risk of acute complications and/or in-hospital death. Overall, 3.2% of the population experienced an adverse event. A simple risk score consisting of 10 readily available variables successfully identified patients at high and low risk of complications. The variables included in the score and assigned points included: age ≥ 70 years (1 point), female (2 points), New York Heart Association class III (1 point) or IV (3 points), atrial fibrillation (1 point), prior valve surgery (3 points), chronic lung disease (2 points), blood urea nitrogen >30 (2 points), reimplantation for reasons other than battery change (6 points), ICD type dual chamber (2 points) or biventricular (4 points), and nonelective ICD implant (3 points). The risk of any in-hospital complication increased from 0.6% among patients with a score of ≤ 5 (8.4% of the population) to 8.4% among patients with ≥ 19 risk points (3.9% of the population).
CONCLUSIONS: A simple risk score consisting of readily available clinical variables can identify high- and low-risk subsets of patients undergoing ICD implantation. This information can guide the physician in patient selection and determining the intensity of care required post procedure.
Authors:
David E Haines; Yongfei Wang; Jeptha Curtis
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-05-02
Journal Detail:
Title:  Circulation     Volume:  123     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-17     Completed Date:  2011-07-19     Revised Date:  2011-08-12    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2069-76     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Medicine, Oakland University William Beaumont School of Medicine, Beaumont Hospital, Royal Oak, MI, USA. dhaines@beaumont.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Death, Sudden, Cardiac / epidemiology*
Defibrillators, Implantable / adverse effects*
Female
Humans
Logistic Models
Male
Models, Statistical*
Postoperative Complications / epidemiology*
Prevalence
Registries
Retrospective Studies
Risk Assessment / methods
Risk Factors
Comments/Corrections
Comment In:
Nat Rev Cardiol. 2011 Jul;8(7):364   [PMID:  21606967 ]

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


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