"Effect of Age on In-Hospital Outcomes of Transvenous Lead Extraction f" by Min Choon Tan, Qi Xuan Ang et al.
 

Effect of Age on In-Hospital Outcomes of Transvenous Lead Extraction for Infected Cardiac Implantable Electronic Device

Document Type

Conference Proceeding

Publication Date

5-2024

Publication Title

Heart Rhythm

Abstract

Background: The real-world data on the safety profile of transvenous lead extraction (TLE) for infected cardiac implantable electronic devices (CIED) among elderly patients is not well-established. Objective: This study aimed to evaluate the hospital outcomes between patients of different age groups who underwent TLE for infected CIED. Methods: Using the Nationwide Readmissions Database, our study included patients aged ≥18 years who underwent TLE for infected CIED between 2017 and 2020. We divided the patients into four groups: Group A. Young (,50 years), Group B. Young intermediate (50 - 69 years old), Group C. Older intermediate (70 - 79 years old), and Group D. Octogenarian (≥80 years old). We then analyzed the in-hospital outcome between these age groups. Results: A total of 5,712 patients who were admitted for TLE of infected CIED were included in this study: 982 (9.0%) patients in group A, 4,234 (38.7%) patients in group B, 3,204 (29.3%) patients in group C and 2,508 (23.0%) of patients in group D. Post-procedurally, the risk of early mortality increased with older age (Group B vs Group A: OR: 1.92, 95% CI: 1.19-3.09, p,0.01; Group C vs Group A: OR: 2.47, 95% CI: 1.51-4.04, p,0.01; Group D vs Group A: OR: 2.82, 95% CI: 1.69-4.72, p,0.01). The risk of non-home discharge also increased in elderly groups (Group B vs Group A: OR: 1.89; 95% CI: 1.52-2.36; p,0.01; Group C vs Group A: OR: 2.82; 95% CI 2.24-3.56; p,0.01; Group D vs Group A: OR: 4.16; 95% CI: 3.28-5.28; p,0.01). There was no significant difference in hospitalization length and 30-day readmission between different age groups. Apart from a higher rate of open-heart surgery in group A, the procedural complications were comparable between these age groups. Among the reported deaths, 66% occurred greater than seven days from TLE procedure. Conclusion: Our study suggests that elderly patients have poorer in-hospital outcomes following TLE for infected CIED. However, elderly patients do not have a higher risk of procedural complications. These emphasize the similar safety profile of TLE for infected CIED in patients of different ages but also highlight the importance of the need for careful post-TLE management in these elderly patients.

Volume

21

Issue

5S

First Page

S664

Comments

Heart Rhythm Society Annual Meeting, May 16-19, 2024, Boston, MA

Last Page

S665

DOI

10.1016/j.hrthm.2024.03.1637

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