Author + information
- John Dodson,
- Matthew Reynolds,
- Haikun Bao,
- Sana M. Al-Khatib,
- Eric Peterson,
- Mark Kremers,
- Michael Mirro and
- Jeptha Curtis
To assist hospitals’ efforts to improve the outcomes of patients undergoing ICD implantation, we developed and validated a simple scoring system from the NCDR ICD RegistryTM to characterize patient risk and benchmark hospital performance.
We analyzed data from 247,752 patients undergoing ICD implantation between 4/2010 and 3/2012 in the NCDR ICD registry. The population was divided into a derivation (70%) and a validation (30%) cohort. Multivariable logistic regression was used to identify factors associated with adverse in-hospital outcomes (complications or mortality). A simple risk score was then developed based on beta estimates derived from the model.
Mean age of the population was 67.3 years, 27% were female, and 48% had a history of prior ICD or pacemaker. Overall 4684 (1.9%) of patients experienced in-hospital complications or death. Thirteen factors were independently associated with an increased risk of adverse outcomes (Table). Model performance was similar in the derivation and validation cohorts (C statistics = 0.72 and 0.71, respectively). The risk score characterized patients into low and high risk subgroups (score of -2-10 points, 0.4% risk; score of >40 points, 9.8% risk).
Patients’ risk for in-hospital complications or mortality following ICD placement can be predicted based on a simple risk scoring algorithm. This can be used both to inform patient decision-making and to benchmark hospital performance.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias: Devices IV – Ethical and Economic Issues Related to Arrhythmia Devices
Abstract Category: 8. Arrhythmias: Devices
Presentation Number: 1277-34
- 2013 American College of Cardiology Foundation