Abstract 14833: National Trends in Complications and 30-day Re-hospitalization After Lead Removal/extraction: Analysis From a Cohort Of 42,878 Patients
Introduction: As the US population ages and indications for cardiac device implantation expand, there is a concomitant increase in patients undergoing lead removal/extraction (LR/E).. We sought to examine trends in outcomes and complications associated with LR/E.
Methods: We conducted a retrospective analysis using data from a large U.S. commercial insurance database (privately insured and Medicare Advantage patients) identifying all patients undergoing LR/E between 2004 and 2013 with at least one year continuous medical plan enrollment prior to LR/E (to identify baseline comorbidities). Using ICD9 codes and CPT codes, major complications (hemorrhage requiring transfusion, vascular injury, pericardial complications, respiratory complications, cerebrovascular complications, and requirement for cardiac surgery) associated with LR/E and 30-day readmission rates were evaluated.
Results: Among 42,878 patients who underwent LR/E (median age of 62 ( 54, 72) years, 70% male); approximately 1 in 40 experienced a major adverse event (2.4%) during the study period. Respiratory complications were the most common complication and 311 patients required cardiac surgery. 30-day readmission occurred in 11.1% of the total population. The most common reasons for readmission were heart failure exacerbation (18.7%) and device related complications (13.2%).
Conclusion: The observed complication rates after LE/R in clinical practice are similar to those seen in recent clinical trials and have been relatively stable over the past 10 years.
Author Disclosures: S.K. Mulpuru: None. P.A. Noseworthy: None. L.R. Sangaralingham: None. R. Mawangi: None. A.J. Deshmukh: None. N.D. Shah: None. A.M. Killu: None. S.J. Asirvatham: Consultant/Advisory Board; Modest; Abiomed, Atricure, Biotronik, Biosense Webster, Boston Scientific, Medtronic, Medtelligence, St. Jude, Sanofi-Aventis, Wolters-Kluver, Elsevier, Zoll. Y. Cha: None. P.A. Friedman: Research Grant; Modest; St. Jude Medical. Ownership Interest; Modest; Aegis Medical, NeoChord, Preventice, Sorin. Consultant/Advisory Board; Modest; Medtronic, Leadex, Boston Scientific.
- © 2015 by American Heart Association, Inc.