Correlation of waiting time with adverse events in patients admitted for nonelective permanent pacemaker implantation.
OBJECTIVE
To determine the effect of a dedicated permanent pacemaker implantation procedure room on waiting time and waiting time-related morbidity.


METHODS
Retrospective chart review.


METHODS
Two tertiary care teaching hospitals in southern Ontario; one with a dedicated procedure room (centre B) and one without (centre A).


METHODS
Two hundred and fourteen consecutive patients who required permanent pacing urgently or emergently.


METHODS
Charts were examined retrospectively at centre A (131 patients) and centre B (83 patients) to determine the waiting time for and the number of preoperative adverse events in nonelective permanent pacemaker implantation.


RESULTS
Patients in centre A waited a mean of 4.5 +/- 3.0 days while patients in centre B waited a mean of 1.9 +/- 1.6 days (P = 0.0001). Centre A patients experienced a total of 57 adverse events that were likely or possibly related to the waiting period, while patients at centre B experienced eight such events (P < 0.0001). Thirty-three per cent of the centre A patients experienced at least one adverse event, while 8% of centre B patients experienced at least one adverse event (P < 0.00001). Of the centre A patients who waited for more than six days (26 patients), 58% had at least one adverse event, compared with 26% of those who waited less than six days (105 patients, P = 0.0009).


CONCLUSIONS
Delays in implanting nonelective permanent pacemakers are strongly associated with an increase in adverse events. Measures to shorten the waiting time are likely to result in a reduction in morbidity in conjunction with a beneficial impact on health care resource utilization.
Division of Cardiology, University of Western Ontario, London. drsimpson@msn.com
C S
CS
Simpson
M A
MA
Fisher
M J
MJ
Curtis
A D
AD
Krahn
H
H
Abdollah
S R
SR
Raj
F J
FJ
Brennan
G J
GJ
Klein
R
R
Yee
D006801:Humans; D010138:Pacemaker, Artificial; D019736:Prostheses and Implants; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014850:Waiting Lists