Abstract 16242: Symptomatic Bradycardia in the Elderly: Compliance With ACLS Guidelines and in-Hospital Outcome
Objective: to assess if compliance with ACLS Guidelines for the Management of Bradycardia (ACLS-GMB) in a cohort of elderly patients admitted to coronary care unit (CCU) with diagnosis of symptomatic bradycardia (SB) is associated with lower in-hospital mortality and complications.
Methods: in this retrospective cohort study, we included all consecutive patients >65 years with diagnosis of SB admitted to CCU between 2001 and 2007 in a University Hospital. Patient's records were reviewed. Those with acute coronary syndromes or permanent-pacemaker failure were excluded. Based on the presence of ACLS-GMB indications for temporary pacing (TP) and the treatment indicated by treating physician, patients (P) were divided into 2 groups: Group 1 (ACLS compliant): P treated as indicated by ACLS-GMB; and Group 2: P not treated as indicated by ACLS-GMB (includes TP sub-utilization and over-utilization). The incidence of the composite endpoint of in-hospital death and complications (AMI, stroke, resuscitated arrest, acute renal failure and infections) was assessed in each group.
Results: we included 116 P, mean age 83 (IQR 75–87), 30% male, mean heart rate 38 min−1 (IQR 33–40). In-hospital mortality was 7.8% and incidence of the composite of in-hospital death or complications was 27%. Eighty two patients were included in Group 1 (70.6%) and 34 in Group 2 (29.4%). Incidence of the composite endpoint was 19.5% in Group 1 and 44.1% in Group 2 (p=0.006: OR=0.3 [CI95% 0.13–0.73]).
Conclusion: in our retrospective cohort of elderly patients, compliance with ACLS Guidelines for Management of Bradycardia was associated with lower incidence of in-hospital death and complications.
- © 2010 by American Heart Association, Inc.