Mohamed, M, Greenspon, A, van Spall, H, Volgman, A, Sharma, P, Alraies, MC, Kwok, CS ORCID: https://orcid.org/0000-0001-7047-1586, Martin, G, Zachariah, D, Patwala, A and Mamas, M ORCID: https://orcid.org/0000-0001-9241-8890 (2019) Sex differences in rates and causes of 30-day readmissions after cardiac electronic device implantations: insights from the Nationwide Readmissions Database. International Journal of Cardiology.

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Abstract

Background

Women undergoing cardiac implantable electronic device (CIED) implantation are at a higher risk of procedure-related complications. The present study examined sex differences in rates and causes of 30-day readmissions following CIED implantation.
Methods

Using the United States Nationwide Readmissions Database (NRD), all adults who had undergone CIED implantation (cardiac resynchronization therapy (CRT), permanent pacemakers (PPM) and implantable cardioverter defibrillators (ICD)) between January 2010 and September 2015 were included. We compared rates, trends and causes of 30-day readmissions between sexes, and examined associations between sex and outcomes (adjusted odds ratios (aOR) and 95% confidence intervals (CI)).
Results

Out of 1,155,992 index hospitalizations for CIED implantation, 43.1% of the patients were women. All-cause 30-day readmissions were persistently higher in women than men but declined in both sexes over the study period, more so in women (women vs. men; 2010: 15.0% vs. 14.1%; 2015: 13.7% vs.13.4%). Women were at higher odds of readmission due to cardiac (aOR 1.22, 95%CI 1.20–1.24) and device-related complications (aOR 1.18, 95%CI 1.15–1.20) compared to men, but no difference odds of all-cause readmission were found between sexes (women: aOR 0.998, 95%CI 0.997–1.008). The most common cardiac and non-cardiac causes of readmission were heart failure and infection, respectively, and these were similar in both sexes (men vs. women: 17.8% vs. 17.6% and 10.7% vs. 10.8%, respectively).
Conclusion

Women are persistently at higher risk of readmission due to cardiac causes and device-related complications compared to men over a six-year period, but no difference in all-cause readmissions was found between sexes.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) will be available online via Elsevier at https://doi.org/10.1016/j.ijcard.2019.12.012 - please refer to any applicable terms of use of the publisher.
Subjects: R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
R Medicine > RD Surgery > RD32 Operative surgery. Technique of surgical operations
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Depositing User: Symplectic
Date Deposited: 09 Dec 2019 15:51
Last Modified: 16 Dec 2019 13:01
URI: https://eprints.keele.ac.uk/id/eprint/7356

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