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Trends in Hospital Admissions for and Readmissions After Cardiac Implantable Electronic Device Procedures in the United States: An Analysis From 2010 to 2014 Using the National Readmission Database

      Abstract

      Objective

      To evaluate inpatient trends in de novo complete cardiac implantable electronic device (CIED) procedures and subsequent all-cause 30-day readmissions in the United States.

      Patients and Methods

      We accessed the National Readmission Database to identify CIED implantation-related hospitalizations between January 1, 2010, and December 31, 2014, using International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes. In-hospital mortality and postprocedure all-cause 30-day readmissions were also analyzed.

      Results

      During the study period, a total of 800,250 CIED implantation hospitalizations were identified across the United States, with an in-hospital mortality rate of 0.9% (7423 of 800,250) and a 29% decrease in CIED-related index hospitalizations (188,086 in 2010 vs 134,276 in 2014). The all-cause 30-day readmission rate for the entire cohort was 13% (106,505 of 800,250), decreasing from 14% (26,134 of 188,085) in 2010 to only 13% (17,154 of 134,276) by 2014. Dual-chamber pacemakers were the most frequently implanted in-hospital CIEDs (473,615 of 800,250 [59%]). The most common cause for readmission was heart failure exacerbation, which remained unchanged over the study period.

      Conclusion

      Our data reveal a steady decline in overall in-hospital CIED implantations and only a modest decline in readmission rates. The cause for this decline may be an impact of medical and regulatory changes guiding CIED implantations, but it deserves further investigation.

      Abbreviations and Acronyms:

      AICD (automatic implantable cardioverter-defibrillator), CIED (cardiac implantable electronic device), CRT-D (cardiac resynchronization therapy–defibrillator), CRT-P (cardiac resynchronization therapy–pacemaker), ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification), NRD (National Readmission Database)
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