In-hospital complications after implantation of cardiac implantable electronic devices: Analysis of a national inpatient database in Japan

Abstract

Background: Complications after implantation of cardiac implantable electronic devices (CIEDs), including permanent pacemakers (PMs) and other CIEDs, are associated with increased patient mortality and healthcare costs. This study aimed to investigate overall complications after implantation of CIEDs, analyze the associated risk factors, and compare complications after PM implantation between hospitals that performed only PM implantations (PM-only hospitals) and hospitals that implanted other CIEDs, as well as PMs (all-CIED hospitals).

Methods: Using the Japanese Diagnosis Procedure Combination database, we retrospectively collected data on inpatients who underwent CIED implantation from 1 July 2010 to 31 March 2014.

Results: A total of 77,324 patients were identified, including 64,951 patients with PMs and 12,373 with other CIEDs. The overall incidences of in-hospital complications were 2.5% in patients with PMs and 2.1% in those with other CIEDs. The incidences of pocket infections, pocket problems, device- and lead-related problems, and sepsis were 0.9%, 0.5%, 0.4%, and 0.3%, respectively. The crude proportion of complications after PM implantation was higher in the PM-only hospitals than in the all-CIED hospitals (3.1% vs. 2.1%), but the multivariable logistic regression analysis showed no significant difference (odds ratio, 1.29; 95% confidence interval, 0.99-1.68).

Conclusion: After adjusting for patient backgrounds, the occurrence of complications after PM implantation was not significantly different between patients in PM-only hospitals and those in all-CIED hospitals.

Keywords: Cardiac resynchronization therapy; Complication; Implantable cardioverter defibrillator; Pacemaker; Risk factor.