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Mortality and 30-day Readmission Rates Following Inpatient Leadless Pacemaker Implantation: Insights from the Nationwide Readmissions Database



Background:

This study aimed to provide real-world data on the rates, trends, and predictors of in-hospital complications and 30-day readmission following leadless pacemaker (LP) implantation.


Methods:

We analyzed leadless or conventional pacemaker implantations using the all-payer, nationally representative Nationwide Readmissions Database between 2017 and 2019. The national trends of in-hospital mortality, in-hospital complications, and 30-day readmission rates after pacemaker implantation were analyzed. Mixed-effects multivariable logistic regression analysis was performed to identify factors associated with in-hospital death and 30-day readmission in LP patients.


Results:

A total of 137,732 admissions (age: 78 [70-85] years, 5,986 LP implantations) were analyzed. The in-hospital mortality, overall in-hospital complications, and 30-day readmission rates after LP implantations were 5.0%, 16%, and 16%, respectively. In LP recipients, the national estimate of in-hospital mortality declined from 10.9% in the second quarter of 2017 to 4.3% in the fourth quarter of 2019 (P<0.001). Furthermore, the national estimate of overall complications declined from 20.6% in the second quarter of 2017 to 13.0% in the fourth quarter of 2019 (P<0.001). In LP recipients, female sex, history of chronic kidney disease, heart failure, and malnutrition were factors associated with in-hospital death.


Conclusions:

Analysis of the nationally representative claims database from the United States showed in-hospital mortality and complication rates (for LP implantation performed during hospitalization) of 5.0% and 16%, respectively. Although these rates showed a decreasing trend over time, ongoing surveillance is needed for the safety of LP implantation.



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