Clinical InvestigationCongestive Heart FailureShort-term mortality and cost associated with cardiac device implantation in patients hospitalized with heart failure
Section snippets
Methods
We used PREMIER's Perspective Comparative Database for calendar years 2004 and 2005. PREMIER is a hospital performance improvement alliance created and owned by several hundred hospitals and health systems.33 Data validation and audits are performed by PREMIER to ensure quality. The database incorporates detailed patient level data from acute care hospitals in a large national sample organized by discharge month (n = 240 hospitals).
Variables within PREMIER include patient demographic
Results
The number of hospitalizations with ICD-9 procedure codes for an implantable cardiac device and a primary or secondary ICD-9 diagnosis for HF was 27,907. Patients were predominantly male, white, and older (mean [SD] age 68.4 [12.0] years, median age 70.0 years) (Table I). The most common non-HF primary ICD-9 diagnosis code was paroxysmal ventricular tachycardia (427.1, 11.0%). The most common secondary ICD-9 diagnoses included hypertension (54.1%), diabetes (35.3%), and chronic obstructive lung
Discussion
A major transformation in the care of patients with HF occurred with the advent of transvenous ICDs followed by the introduction of cardiac resynchronization devices alone or in combination with ICD technology. The clinical trials that formed the basis for regulatory approval of these devices did not in general enroll patients with advanced HF; when these patients were included, they tended to be ambulatory.28 Furthermore, the language used in clinical practice guidelines of major professional
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Cited by (0)
The study is supported in part by National Institutes of Health RO1-AG021515 (Dr P Hauptman).
Dr Hauptman: Grant support from the National Institutes of Health; local site coinvestigator on the SCD-HeFT trial. Mr Swindle: No relevant financial relationships. Dr Burroughs: No relevant financial relationships. Dr Schnitzler: No relevant financial relationships.