Daley W R, Kaczmarek R G
Food and Drug Administration, Center for Devices and Radiological Health, Office of Surveillance and Biometrics, Rockville, Maryland, USA.
J Am Geriatr Soc. 1998 Aug;46(8):1016-9. doi: 10.1111/j.1532-5415.1998.tb02760.x.
This study estimates the age distribution of older patients (>64 years) receiving implantable cardiac pacemakers in non-federal US hospitals and determines major characteristics of this group using a massive, nationally representative sample of inpatient discharge records.
Discharge records were obtained from the 1992 Nationwide Inpatient Sample. Correlation with census data from 1992 was used to determine age and gender specific rates.
The Nationwide Inpatient Sample is a 20% stratified probability sample of non-federal US hospitals.
Records of all recipients (26,425) of an initial or replacement pacemaker were selected.
Individuals 65 years of age and older received an estimated 131,361 initial and replacement pacemaker pulse generators (87% of the total) in non-federal US hospitals in 1992. Pacemaker implantation was performed in urban teaching hospitals (28.9%), non-teaching urban hospitals (57.8%), and rural hospitals (13.3%). The age specific implantation rates per 100,000 population were 226.5 (age 65-74 years), 585.9 (age 75-84 years), 874.9 (age 85-94 years), and 540.4 (more than 94 years). The age-adjusted rate for men was 70% greater than the corresponding rate for women. Major diagnoses of implant recipients included atrioventricular block (37.8%) and atrial fibrillation (28.5%). Two percent of pacemaker recipients died before discharge.
The rate of pacemaker implantation increases sharply up to age 95. As the number of older people in the US population grows, particularly those in the age ranges greater than 75 and 85 years, a sharply increased number of pacemakers will be implanted unless other factors decrease the need for these devices. The data also demonstrate diffusion of this technology from academic centers.
本研究估算了美国非联邦医院中接受植入式心脏起搏器的老年患者（>64岁）的年龄分布，并使用大量具有全国代表性的住院出院记录样本确定该群体的主要特征。
从1992年全国住院患者样本中获取出院记录。利用与1992年人口普查数据的相关性来确定特定年龄和性别的发生率。
全国住院患者样本是美国非联邦医院的20%分层概率样本。
选取了所有初次或更换起搏器的接受者（26425例）的记录。
1992年，65岁及以上的个体在美国非联邦医院接受了约131361台初次和更换的起搏器脉冲发生器（占总数的87%）。起搏器植入手术在城市教学医院（28.9%）、非教学城市医院（57.8%）和农村医院（13.3%）进行。每10万人口的特定年龄植入率分别为226.5（65 - 74岁）、585.9（75 - 84岁）、874.9（85 - 94岁）和540.4（94岁以上）。男性的年龄调整率比女性相应率高70%。植入接受者的主要诊断包括房室传导阻滞（37.8%）和心房颤动（28.5%）。2%的起搏器接受者在出院前死亡。
起搏器植入率在95岁之前急剧上升。随着美国老年人口数量的增加，特别是75岁以上和85岁以上年龄段的人口，除非其他因素减少对这些设备的需求，否则起搏器的植入数量将急剧增加。数据还表明了这项技术从学术中心的扩散情况。
