Author + information
- Gbolahan Ogunbayoa,b,
- Suartcha Prueksaritanonda,b,
- Odunayo Olorunfemia,b,
- Ayman Elbadawia,b,
- Deola Saheeda,b and
- Samy Elayia,b
Background: Pneumothorax (PTX) is a known complication of cardiac implantable electronic device (CIED) procedures. Our study describes characteristics and clinical predictors of patients who developed PTX after a CIED procedure.
Methods: We reviewed the National Inpatient Sample database for patients who underwent a CIED procedure during their hospital admission. We described clinical predictors associated with the occurrence of PTX in these patients.
Results: We identified 871,551 patients with a CIED procedure between 1998 and 2013: 65.7% received a permanent pacemaker (n=572,937), 20.5% received an automatic implantable cardioverter defibrillator (n=178,462), 10.4% received cardiac resynchronization therapy (n= 90,898) and 3.5% had lead revision/addition (n=30,767). Of these, 11,659 (1.3%) had a PTX. The mean age of the total population was 73.1±12.8 years and 42.7% were female. Patients who developed PTX were more likely to be female (OR: 1.94, 95% CI 1.87-2.02; p<.001), over 80 years old (OR: 1.43, 95% CI 1.38-1.49; p<.001) and Caucasian (OR: 1.17, 95% CI 1.13-1.22; p<.001). PTX was more common in COPD patients (1.61, 95% CI 1.54-1.69; p<.001). Black race and obese patients (BMI of 30kg/m2 or higher) had significantly lower occurrence of PTX (OR: 0.74, 95% CI 0.68-0.80; p<.001 and OR: 0.37, 95% CI 0.29-0.47; p<.001 respectively). Permanent pacemaker implantation had a significant association with PTX (OR: 1.30, 95% CI 1.24-1.36; p<.001) as well as did cardiac resynchronization therapy (OR: 1.10, 95% CI 1.03-1.20). Patients in academic centers had a slightly reduced odds for PTX (OR: 0.94 95% CI 0.91-0.98; p=.002), while both rural and non-academic urban centers had a slightly higher odds for PTX (OR: 1.08 95% CI 1.01-1.16, P=.036 and OR: 1.06, 95% CI 1.02-1.10, p=.003).
Conclusions: Pneumothorax is a relatively common complication of cardiac implantable electronic device procedure. Age (older), gender (female), race (Caucasian), body mass index less than 30kg/m2, presence of chronic obstructive pulmonary disease and pacemaker implantation were associated with increased risk for developing this complication. Patients treated at academic centers had lower odds for pneumothorax.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Arrhythmias and Clinical EP: Devices 1
Abstract Category: 5. Arrhythmias and Clinical EP: Devices
Presentation Number: 1109-084
- 2017 American College of Cardiology Foundation