TY - JOUR
T1 - Incidence, predictors and outcomes of hematoma after ICD implantation
T2 - An analysis of a nationwide database of 85,276 patients
AU - Sridhar, Arun Raghav Mahankali
AU - Yarlagadda, Vivek
AU - Kanmanthareddy, Arun
AU - Parasa, Sravanthi
AU - Maybrook, Ryan
AU - Dawn, Buddhadeb
AU - Reddy, Yeruva Madhu
AU - Lakkireddy, Dhanunjaya
N1 - Publisher Copyright:
© 2016 Indian Heart Rhythm Society
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Background Pocket hematoma is one of the most common complications following cardiac device implantation. This study examined the impact of this complication on in-hospital outcomes following Implantable Cardioverter Defibrillator (ICD) implantation. Methods Data from Nationwide Inpatient Sample (NIS) 2010 was queried to identify all primary implantations of ICDs and Cardiac Resynchronization Therapy Defibrillators (CRT-D) during the year 2010 using ICD-9 codes. We then identified the patients who experienced a procedure related hematoma during the hospital stay. We compared the outcomes of the patients with and without a hematoma complication. All analyses were performed using SPSS 20 complex samples using appropriate weights to adjust for the complex sampling design of the national database. Results Out of a total of 85,276 primary ICD implantations in the year 2010, 2233 (2.6% of the implantations) were complicated by a hematoma. Increased age (p < 0.001), and comorbidities such as congestive heart failure (odds ratio (OR) – 1.86, p < 0.001), coagulopathy (OR - 2.3, p < 0.001) and renal failure (OR - 1.52, p < 0.001) were associated with an increased risk of pocket hematoma formation. Patients who developed a hematoma had a longer hospitalization (9.1 days versus 5.5 days, p < 0.001) and higher in-hospital costs ($56,545 versus $47,015, p < 0.001) compared to patients who did not have a hematoma. Overall mortality associated with ICD implantation was low (0.6%), and hematoma formation did not adversely affect mortality (0.6% versus 0.4%, p = 0.63). Conclusion Hematoma occurs infrequently after ICD implantation, however, it adversely impacts the cost of procedure and length of stay.
AB - Background Pocket hematoma is one of the most common complications following cardiac device implantation. This study examined the impact of this complication on in-hospital outcomes following Implantable Cardioverter Defibrillator (ICD) implantation. Methods Data from Nationwide Inpatient Sample (NIS) 2010 was queried to identify all primary implantations of ICDs and Cardiac Resynchronization Therapy Defibrillators (CRT-D) during the year 2010 using ICD-9 codes. We then identified the patients who experienced a procedure related hematoma during the hospital stay. We compared the outcomes of the patients with and without a hematoma complication. All analyses were performed using SPSS 20 complex samples using appropriate weights to adjust for the complex sampling design of the national database. Results Out of a total of 85,276 primary ICD implantations in the year 2010, 2233 (2.6% of the implantations) were complicated by a hematoma. Increased age (p < 0.001), and comorbidities such as congestive heart failure (odds ratio (OR) – 1.86, p < 0.001), coagulopathy (OR - 2.3, p < 0.001) and renal failure (OR - 1.52, p < 0.001) were associated with an increased risk of pocket hematoma formation. Patients who developed a hematoma had a longer hospitalization (9.1 days versus 5.5 days, p < 0.001) and higher in-hospital costs ($56,545 versus $47,015, p < 0.001) compared to patients who did not have a hematoma. Overall mortality associated with ICD implantation was low (0.6%), and hematoma formation did not adversely affect mortality (0.6% versus 0.4%, p = 0.63). Conclusion Hematoma occurs infrequently after ICD implantation, however, it adversely impacts the cost of procedure and length of stay.
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U2 - 10.1016/j.ipej.2016.10.005
DO - 10.1016/j.ipej.2016.10.005
M3 - Article
AN - SCOPUS:85002706072
VL - 16
SP - 159
EP - 164
JO - Indian Pacing and Electrophysiology Journal
JF - Indian Pacing and Electrophysiology Journal
SN - 0972-6292
IS - 5
ER -