Mohamed, MO ORCID: https://orcid.org/0000-0002-9678-5222, van Spall, H, Morillo, C, Wilton, S, Kontopantelis, E, Rashid, M ORCID: https://orcid.org/0000-0001-9725-1583, Wu, P ORCID: https://orcid.org/0000-0003-0011-5636, Patwala, A and Mamas, M ORCID: https://orcid.org/0000-0001-9241-8890 (2022) The impact of Charlson Comorbidity Index on de novo CIED procedural outcomes in the United States. Mayo Clinic Proceedings, 97 (1). pp. 88-100.

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CIED CCI paper Final version MCP.docx - Accepted Version
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Abstract

Objective
To investigate the utility of Charlson comorbidity index (CCI) as a measure of comorbidity burden to predict procedural outcomes after de novo cardiac implantable electronic device (CIED) implantation.
Methods
All de novo CIED implantations in the United States National Inpatient Sample between 2015 and 2018 were retrospectively analyzed, stratified by CCI score (0=no comorbidity burden, 1=mild, 2=moderate, ≥3=severe). Multivariable logistic regression models were performed to examine the association between unit CCI score (scale) and in-hospital outcomes (major adverse cerebrovascular and cardiovascular events [MACCE]: composite of all-cause mortality, acute ischemic stroke, thoracic and cardiac complications, and device-related complications; and MACCE individual components).
Results
Of 474,475 CIED procedures, the distribution of CCI score was as follows: CCI=0 (17.7%), CCI=1 (21.8%), CCI=2 (18.7%), and CCI=3+ (41.8%). Charlson comorbidity index score was associated with increased odds ratios of MACCE (1.10; 95% CI, 1.09 to 1.11), all-cause mortality (1.23; 95% CI, 1.21 to 1.25), and acute stroke (1.45; 95% CI, 1.44 to 1.46). This finding was consistent across all CIED groups except the cardiac resynchronization therapy groups in which CCI was not associated with increased risk of mortality. A higher CCI score was not associated with increased odds of procedural (thoracic and cardiac) and device-related complications.
Conclusion
In a nationwide cohort of CIED procedures, higher comorbidity burden as measured by CCI score was associated with an increased risk of in-hospital mortality and acute ischemic stroke, but not procedure-related (thoracic and cardiac) or device-related complications. Objective assessment of comorbidity burden is important to risk-stratify patients undergoing CIED implantation for better prognostication of their in-hospital survival.

Item Type: Article
Additional Information: The final version of this accepted manuscript and all relevant information related to it, including copyrights, can be found on the publisher website at; https://www.sciencedirect.com/science/article/pii/S002561962100611X
Subjects: E History America > E11 America (General)
E History America > E151 United States (General)
R Medicine > R Medicine (General)
R Medicine > R Medicine (General) > R735 Medical education. Medical schools. Research
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 07 Jul 2021 09:46
Last Modified: 21 Feb 2022 14:31
URI: https://eprints.keele.ac.uk/id/eprint/9785

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