Khan Muhammad Zia, Alyami Bandar, Alruwaili Waleed, Nguyen Amanda T, Mendez Melody, Leon William E, Devera Justin, Hayat Hafiz Muhammad Sohaib, Naveed Abdullah, Asad Zain Ul Abideen, Agarwal Siddharth, Balla Sudarshan, Darden Douglas, Munir Muhammad Bilal
Division of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, WV, USA.
Division of Cardiology, University of California Davis, Sacramento, CA, USA.
J Interv Card Electrophysiol. 2025 Aug;68(5):1027-1033. doi: 10.1007/s10840-024-01936-2. Epub 2024 Oct 22.
To determine differences in baseline characteristics and outcomes of leadless pacemaker implantation based on sex.
For the purpose of this study, data were extracted from the National Inpatient Sample database for years 2016-2020. The study group was then stratified based on sex. Baseline characteristics and in-hospital outcomes including complications were then analyzed in each group. Multivariable logistic regression models were created to analyze the association of sex with important outcomes of mortality, major complications (defined as pericardial effusion requiring intervention and any vascular complication), prolonged length of stay (defined as > 6 days), and increased cost of hospitalization (defined as median cost > 34,098$) after leadless pacemaker implantation.
A total of 29,000 leadless pacemakers (n in women = 12,960, 44.7%) were implanted during our study period. Women were found to have an increased burden of co-morbidities as compared to men. In the adjusted analysis, the likelihood of mortality (aOR 1.27, 95% CI 1.14-1.43), major complications (aOR 1.07, 95% CI 0.98-1.18), prolonged length of stay (aOR 1.09, 95% CI 1.04-1.15), and increased hospitalization cost (aOR 1.14, 95% CI 1.08-1.20) were higher in women as compared to men after leadless pacemaker implantation.
Important and significant differences exist in leadless pacemaker implantation in women as compared to men. These findings highlight the need for evaluating etiologies behind such differences with a goal of improving outcomes in all patients after leadless pacemaker implantation.
确定基于性别的无导线起搏器植入的基线特征和结果差异。
为了本研究的目的，从2016 - 2020年的国家住院样本数据库中提取数据。然后根据性别对研究组进行分层。接着分析每组的基线特征和包括并发症在内的住院结局。创建多变量逻辑回归模型来分析性别与无导线起搏器植入后死亡率、主要并发症（定义为需要干预的心包积液和任何血管并发症）、住院时间延长（定义为>6天）以及住院费用增加（定义为中位数费用>34,098美元）等重要结局之间的关联。
在我们的研究期间，共植入了29,000个无导线起搏器（女性n = 12,960，占44.7%）。发现女性的合并症负担比男性更重。在调整分析中，与男性相比，女性在无导线起搏器植入后死亡率（调整后比值比1.27，95%置信区间1.14 - 1.43）、主要并发症（调整后比值比1.07，95%置信区间0.98 - 1.18）、住院时间延长（调整后比值比1.09，95%置信区间1.04 - 1.15）以及住院费用增加（调整后比值比1.14，95%置信区间1.08 - 1.20）的可能性更高。
与男性相比，女性在无导线起搏器植入方面存在重要且显著的差异。这些发现凸显了评估这些差异背后病因的必要性，目标是改善所有患者在无导线起搏器植入后的结局。
