Document Detail

Relationship between rehospitalization and future death in patients treated for potentially lethal arrhythmia.
MedLine Citation:
PMID:  11573708     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: It is generally considered that death is the only appropriate endpoint to evaluate interventions for preventing death; however, this belief may be based on the previous use of inappropriate or inadequate surrogates for death. The aim of this study was to evaluate whether rehospitalization following implementation of an intervention is a reasonable surrogate for death. METHODS AND RESULTS: The time from discharge following intervention to rehospitalization was evaluated for 997 patients discharged after baseline hospitalization in the Antiarrhythmics Versus Implantable Defibrillators Trial. The relationship between rehospitalization for various reasons and subsequent death was compared in the two treatment arms to assess the adequacy of rehospitalization as a surrogate for death. Included were rehospitalization for: any reason, a cardiac problem, a noncardiac problem, new or worsened congestive heart failure (CHF), an acute coronary syndrome, and a cardiac procedure. For all of the reasons except cardiac procedure, rehospitalization was associated with a substantially increased hazard for subsequent death. Rehospitalization for new or worsened CHF was most closely (that is, temporally) related to subsequent death and was the only reason for rehospitalization, which fully explained the treatment effect of implantable cardiac defibrillators compared with antiarrhythmic drugs on death. CONCLUSION: Rehospitalization is a significant risk factor for subsequent death. However, only rehospitalization for new or worsened CHF appears to be a potential surrogate for death in the setting of antiarrhythmic interventions.
A P Hallstrom; H L Greene; B L Wilkoff; D P Zipes; E Schron; R B Ledingham;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  12     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-27     Completed Date:  2002-02-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  990-5     Citation Subset:  IM    
University of Washington, Seattle, USA.
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MeSH Terms
Heart Failure / physiopathology
Patient Readmission*
Proportional Hazards Models
Risk Factors
Stroke Volume
Tachycardia, Ventricular / physiopathology,  therapy*
Ventricular Fibrillation / physiopathology,  therapy*
Grant Support
N01-11C-25117//PHS HHS

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