Impact of the implantable cardioverter-defibrillator on rehospitalizations

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Serval ID
serval:BIB_44F9D52506E7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of the implantable cardioverter-defibrillator on rehospitalizations
Journal
European Heart Journal
Author(s)
Valenti  R., Schlapfer  J., Fromer  M., Fischer  A., Kappenberger  L.
ISSN
0195-668X (Print)
Publication state
Published
Issued date
10/1996
Volume
17
Number
10
Pages
1565-71
Language
english
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Oct
licence nationale
Abstract
Patients who survive out-of-hospital ventricular tachycardia or ventricular fibrillation are at risk of sudden cardiac death and often return to hospital after initial discharge. The frequency and duration of readmittance to hospital are not well known. Thus, the purpose of this study was to evaluate the impact of the implantable cardioverter defibrillator on frequency and duration of hospitalizations. METHODS: Between 1989 and 1993, 38 consecutive patients who had drug-refractory ventricular tachyarrhythmias were selected for the study. A total of 38 patients were implanted with the implantable cardioverter-defibrillator in accordance with the guidelines of the European Society of Cardiology. This analysis includes 35 of the 38 patients (92%). All hospitalizations which occurred one year before and one year after were studied. Clinical information for all patients was obtained by consulting medical records and by interviewing personal general practitioners. RESULTS: The annual number of hospitalizations before and after implantation of the implantable cardioverter-defibrillator was, respectively, 3.28 +/- 2.38 hospitalizations/ patient/year and 0.88 +/- 1.23 hospitalizations/patient/year (P < 0.05). Before implantation of the implantable cardioverter-defibrillator, patients were hospitalized a mean of 32.94 +/- 24.18 days/patient/year and after, 9.31 +/- 32.14 days/patient/year (P < 0.05). The number of hospitalizations for cardiac reasons decreased by 90%. Before implantation, the most frequent cause was ventricular tachyarrhythmia (47 hospitalizations for ventricular tachycardia and eight for ventricular fibrillation), while after implantation, it was as a result of the shock from the implantable cardioverter-defibrillator (11 hospitalizations). The number of hospitalizations for non-cardiac reasons were similar in the two time periods. Of the 35 patients, 26 (74%) had at least one appropriate successful ventricular tachycardia interrupted by the implantable cardioverter-defibrillator, while 17 patients (49%) had their ventricular fibrillation terminated. There is a significant difference in the rate of hospitalizations to intensive care units (ICU) between the two periods. Before implantation, 30% of hospital days were spent in the ICU, with 3% after. CONCLUSIONS: This study documents that the implantable cardioverter-defibrillator not only reduces the frequency and duration of hospital stays, but reduces admissions to the more expensive units in hospital. Taking into account the reduction in hospitalizations, the payback period for the implantation of an implantable cardioverter-defibrillator is 19 months.
Keywords
Adolescent Adult Aged Cost-Benefit Analysis Defibrillators, Implantable/economics/*statistics & numerical data Female Follow-Up Studies Humans Intensive Care Units/economics/utilization Length of Stay/economics/*statistics & numerical data Male Middle Aged Patient Readmission/economics/*statistics & numerical data Recurrence Switzerland/epidemiology Tachycardia, Ventricular/economics/epidemiology/*therapy Treatment Outcome Ventricular Fibrillation/economics/epidemiology/*therapy
Pubmed
Web of science
Open Access
Yes
Create date
15/02/2008 12:28
Last modification date
25/09/2019 7:09
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