Cardiovascular disease department, College of Medicine, University of Arizona, Phoenix, Arizona.
Hoffman Heart and Vascular Institute, St. Francis Hospital and Medical Center, University of Connecticut School of Medicine, Hartford, Connecticut.
Pacing Clin Electrophysiol. 2020 May;43(5):444-455. doi: 10.1111/pace.13905. Epub 2020 May 2.
Utilization of catheter ablation of ventricular tachycardia (VT) has steadily increased in recent years. Exploring short-term outcomes is vital in health care planning and resource allocation.
The Nationwide Readmissions Database from 2010 to 2014 was queried using the ICD-9 codes for VT (427.1) and catheter ablation (37.34) to identify study population. Incidence, causes of 30-day readmission, in-hospital complications as well as predictors of 30-day readmissions, complications, and cost of care were analyzed.
Among 11 725 patients who survived to discharge after index admission for VT ablation, 1911 (16.3%) were readmitted within 30 days. Paroxysmal VT was the most common cause of 30-day readmission (39.51%). Dyslipidemia, chronic kidney disease (CKD), previous CABG, congestive heart failure (CHF), chronic pulmonary disease, and anemia predicted increased risk of 30-day readmissions. The overall in-hospital complication rate was 8.2% with vascular and cardiac complications being the most common. Co-existing CKD and CHF and the need for mechanical circulatory support (MCS) predicted higher complication rates. Similarly increasing age, CKD, CHF, anemia, in-hospital use of MCS or left heart catheterization, teaching hospital, and disposition to nursing facilities predicted higher cost.
Approximately one in six patients was readmitted after VT ablation, with paroxysmal VT being the most common cause of the readmission. A complication rate of 8.2% was noted. We also identified a predictive model for increased risk of readmission, complication, and factors influencing the cost of care that can be utilized to improve the outcomes related to VT ablation.
近年来，心室性心动过速（VT）导管消融的应用稳步增加。探索短期结果对于医疗保健规划和资源分配至关重要。
利用 ICD-9 代码 427.1（VT）和 37.34（导管消融），从 2010 年至 2014 年的全国再入院数据库中查询研究人群。分析了 30 天内再入院的发生率、再入院的原因、住院并发症以及 30 天内再入院、并发症和医疗费用的预测因素。
在索引性 VT 消融后存活至出院的 11725 名患者中，有 1911 名（16.3%）在 30 天内再次入院。阵发性 VT 是 30 天内再入院的最常见原因（39.51%）。血脂异常、慢性肾脏病（CKD）、先前的 CABG、充血性心力衰竭（CHF）、慢性肺部疾病和贫血预测 30 天内再入院的风险增加。总的院内并发症发生率为 8.2%，血管和心脏并发症最常见。共存的 CKD 和 CHF 以及需要机械循环支持（MCS）预测更高的并发症发生率。同样，年龄增长、CKD、CHF、贫血、院内使用 MCS 或左心导管检查、教学医院和护理设施的处置预测成本增加。
大约六分之一的 VT 消融患者在出院后再次入院，阵发性 VT 是再入院的最常见原因。并发症发生率为 8.2%。我们还确定了一个可用于提高 VT 消融相关结果的风险、并发症和影响医疗费用的因素的预测模型。
