title: Impact of haematoma after pacemaker and CRT device implantation on hospitalization costs, length of stay, and mortality: a population-based study.
abstract: OBJECTIVE
  Pocket haematoma is a common complication following pacemaker implantation. Impact of this complication on post-procedural outcomes has previously not been systematically studied. We sought to identify the incidence of pocket haematoma after a de novo pacemaker and cardiac resynchronization therapy (CRT) device implantation and evaluate its impact on the hospital outcomes using a large all-payer national inpatient database.
  
  
  RESULTS
  Data from Nationwide Inpatient Sample 2010 was queried to identify all primary implantations of single chamber, dual chamber pacemakers, and biventricular devices during the year 2010 using the appropriate ICD-9 codes. Patients who experienced a procedure-related haematoma during the hospital stay were identified. Of a total of 78,751 primary pacemaker implantations in the year 2010, 1677 (2.1%) of the implantations were complicated by a pocket haematoma. Higher age groups, more complex pacemaker types (BiV > dual chamber > single chamber), and comorbidities such as congestive heart failure and coagulopathy were associated with an increased risk of pocket haematoma formation post-pacemaker implantation. Patients who developed a pocket haematoma had a longer length of stay (8.7 vs. 4.8 days, P < 0.001), higher hospitalization costs ($48,815 vs. $34,324, P < 0.001) and higher in-hospital mortality (2.0 vs. 0.7%, P < 0.001) compared with patients who did not develop a haematoma.
  
  
  CONCLUSIONS
  Haematoma is a relatively common complication associated with pacemaker implantation; however, it adversely impacts in-hospital outcomes.
authors: Division of Cardiovascular Diseases, Cardiovascular Research Institute, The University of Kansas Hospital & Medical Center, Kansas City, KS, USA.
authors: Arun Raghav Mahankali
authors: AR
authors: Sridhar
authors: Division of Cardiovascular Diseases, Cardiovascular Research Institute, The University of Kansas Hospital & Medical Center, Kansas City, KS, USA.
authors: Vivek
authors: V
authors: Yarlagadda
authors: Division of Cardiovascular Diseases, Cardiovascular Research Institute, The University of Kansas Hospital & Medical Center, Kansas City, KS, USA.
authors: Madhu Reddy
authors: MR
authors: Yeruva
authors: Division of Cardiovascular Diseases, Cardiovascular Research Institute, The University of Kansas Hospital & Medical Center, Kansas City, KS, USA.
authors: Arun
authors: A
authors: Kanmanthareddy
authors: Metro Health Medical Center, Case Western Reserve University, Cleveland, OH, USA.
authors: Ajay
authors: A
authors: Vallakati
authors: Division of Cardiovascular Diseases, Cardiovascular Research Institute, The University of Kansas Hospital & Medical Center, Kansas City, KS, USA.
authors: Buddhadeb
authors: B
authors: Dawn
authors: Division of Cardiovascular Diseases, Cardiovascular Research Institute, The University of Kansas Hospital & Medical Center, Kansas City, KS, USA dlakkireddy@kumc.edu.
authors: Dhanunjaya
authors: D
authors: Lakkireddy
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D058406:Cardiac Resynchronization Therapy / Q000191:economics*; D058409:Cardiac Resynchronization Therapy Devices / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006406:Hematoma / Q000453:epidemiology*; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D038801:International Classification of Diseases; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D012044:Regression Analysis; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: In-hospital outcomes; Pacemaker complications; Pacemaker implantation; Pocket haematoma