Khalil Charl, Lazar Sorin, Megaly Michael, Mekritthikrai Raktham, Vipparthy Sharath C, Doukky Rami, Mortada Mohammad E, Huang Henry D, Sharma Parikshit S
Division of Cardiology, Department of Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
Section of Electrophysiology, Division of Cardiology, Department of Medicine, Rush University Medical Center, 1717 W Congress Pkwy/suite 317 Kellogg, Chicago, IL, 60612, USA.
J Interv Card Electrophysiol. 2024 Aug 6. doi: 10.1007/s10840-024-01891-y.
Higher rates of CIED implantations have been associated with an increased rate of lead failures and complications resulting in higher rates of transvenous lead extractions (TLE).
To assess the trends TLE admissions and evaluate the patient related predictors of safety outcomes.
National Readmission Database was queried to identify patients who underwent TLE from January 2016 to December 2019. We conducted a multivariate regression analysis to identify variables associated with in-hospital mortality in patients undergoing TLE. Additionally, we compared trends and outcomes of TLE among patients with prior sternotomy versus those without prior sternotomy and analyzed sex-based differences among patients undergoing TLE.
We identified 30,128 hospitalizations for TLE. The index admission in-hospital mortality rate was 3.21% with cardiac tamponade happening in 1.46% of the admissions. Age, infective endocarditis, CKD, congestive heart failure and anemia were associated with higher in-hospital mortality rates. There was a lower rate of in-hospital mortality in patients with history of prior sternotomy versus patients without (OR 0.72, CI: 0.59-0.87, p-value < 0.001). There was no difference in in-hospital mortality rate between males and females. Females had a shorter length and a higher cost of stay when compared to male gender.
TLE admissions continue to increase. Overall rates of mortality and complications are relatively low. Patients with prior sternotomy had better outcomes and less complications when compared to those without prior sternotomy. Female gender is associated with higher rates of cardiac tamponade, yet shorter length of stay with lower cost.
心脏植入式电子设备（CIED）植入率的提高与导线故障和并发症发生率的增加相关，导致经静脉导线拔除术（TLE）的发生率更高。
评估TLE入院的趋势，并评估与安全结局相关的患者预测因素。
查询国家再入院数据库，以确定2016年1月至2019年12月期间接受TLE的患者。我们进行了多变量回归分析，以确定与接受TLE患者的院内死亡率相关的变量。此外，我们比较了有胸骨切开术史与无胸骨切开术史患者的TLE趋势和结局，并分析了接受TLE患者的性别差异。
我们确定了30128例TLE住院病例。首次入院的院内死亡率为3.21%，1.46%的入院病例发生心脏压塞。年龄、感染性心内膜炎、慢性肾脏病、充血性心力衰竭和贫血与较高的院内死亡率相关。有胸骨切开术史的患者与无胸骨切开术史的患者相比，院内死亡率较低（OR 0.72，CI：0.59-0.87，p值<0.001）。男性和女性的院内死亡率没有差异。与男性相比，女性的住院时间更短，住院费用更高。
TLE入院人数持续增加。总体死亡率和并发症发生率相对较低。与无胸骨切开术史的患者相比，有胸骨切开术史的患者结局更好，并发症更少。女性心脏压塞发生率较高，但住院时间较短，费用较低。
