Hospital readmission after transvenous cardioverter/defibrillator implantation; a single centre study.
OBJECTIVE
Hospital readmission after implantation of cardioverter/defibrillators has a major impact on quality of life and cost-effectiveness in defibrillator patients. Rehospitalization has not been studied in large patient populations with modern transvenous defibrillation systems.


RESULTS
We report on incidence, reasons, time in follow-up, duration and predictors of hospital readmission in 180 patients after transvenous implantation of a cardioverter/defibrillator during a follow-up period of 25+/-18 months. There were 156 readmissions in 79 patients with a 0.87 readmission rate per patient during the time followed, a 0.46 readmission rate per patient-year of follow-up and a 0.38 readmission rate per patient-year of follow-up for cardiac reasons. The majority of readmissions was caused by multiple appropriate shock interventions (26%), battery depletion (19%) and lead- and device-related complications (14%). The time to first hospital readmission was 12+/-9 months for arrhythmia-related and 20+/-16 months for other cardiac-related reasons (P<0.05), and could not be predicted by clinical variables, respectively. The duration of rehospitalization was 14+/-15 days for cardiac-related reasons and 12+/-17 days for arrhythmia-related reasons. Age >60 years was an independent predictor of rehospitalization time per patient-year of follow-up for both cardiac-related (P<0.005) and arrhythmia-related reasons (P<0.05).


CONCLUSIONS
The rate of hospital readmission per patient-year of follow-up is as high as 0.46 after implantation of a modern cardioverter/defibrillator. Rehospitalization time in such patients is significantly longer in the patient cohort >60 years. The majority of readmissions is caused by multiple appropriate shock treatments. Further studies are needed to systematically investigate strategies for the prevention of rehospitalization in modern ICD therapy.
Departments of Cardiology, University of Bonn, Bonn, Germany.
T
T
Korte
W
W
Jung
G
G
Ostermann
C
C
Wolpert
S
S
Spehl
B
B
Esmailzadeh
B
B
Lüderitz
D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D002406:Catheterization, Peripheral; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation*; D004868:Equipment Failure; D006801:Humans; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D011446:Prospective Studies