Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, NSW
Centre for Health Research, University of Wollongong, Wollongong, NSW.
Med J Aust. 2018 Aug 6;209(3):123-129. doi: 10.5694/mja17.01183. Epub 2018 Jul 30.
To quantify the number of implantable cardioverter-defibrillator (ICD) procedures in Australia by year, patient age and sex, and to estimate age group-specific population rates and the associated costs. Design, setting: Retrospective observational study; analysis of Australian National Hospital Morbidity Database hospital procedures data.
Patients with an ICD insertion, replacement, adjustment, or removal procedure code, July 2002 - June 2015.
Number of ICD procedures by procedure year, patient age (0-34, 35-69, 70 years or more) and sex; age group-specific population procedure rates; number of procedures associated with complications.
The number of ICD procedures increased from 1844 in 2002-03 to 6504 in 2014-15; more than 75% of procedures were in men. In 2014-15, the ICD insertion rate for people aged 70 years or more was 78.1 per 100 000 population, 22 per 100 000 for those aged 35-69 years, and 1.40 per 100 000 people under 35. The reported complication rate decreased from 45% in 2002-03 to 19% in 2014-15, partly because of a change in the coding of complications. The number of removals corresponded to at least 4% of the number of insertions each year. The aggregate cost of hospitalisations with an ICD procedure during 2011-14 was $445 644 566.
ICD procedures are becoming more frequent in Australia, particularly in people aged 70 or more. Patterns of care associated with ICD therapy, particularly patient- and hospital-related factors associated with adverse events, should be investigated to better understand and improve patient outcomes.
按年份、患者年龄和性别量化澳大利亚植入式心脏复律除颤器 (ICD) 程序的数量，并估计特定年龄组的人群发生率和相关成本。设计、设置：回顾性观察研究；对澳大利亚国家医院发病率数据库医院程序数据进行分析。
ICD 插入、更换、调整或移除程序代码的患者，2002 年 7 月至 2015 年 6 月。
每年 ICD 程序数量、患者年龄（0-34、35-69、70 岁及以上）和性别；特定年龄组人群程序发生率；与并发症相关的程序数量。
2002-03 年 ICD 程序数量为 1844 例，2014-15 年增加至 6504 例；超过 75%的程序是男性。2014-15 年，70 岁及以上人群 ICD 插入率为每 10 万人 78.1 例，35-69 岁人群为每 10 万人 22 例，35 岁以下人群为每 10 万人 1.40 例。2002-03 年报告的并发症发生率为 45%，2014-15 年降至 19%，部分原因是并发症编码发生了变化。每年的移除数量至少相当于插入数量的 4%。2011-14 年与 ICD 程序相关的住院总费用为 445644566 美元。
在澳大利亚，ICD 程序的应用越来越频繁，特别是在 70 岁及以上的人群中。应调查与 ICD 治疗相关的护理模式，特别是与不良事件相关的患者和医院相关因素，以更好地了解和改善患者的预后。
