Frailty may independently predict in-hospital mortality in patients undergoing leadless pacemaker implantation
In the realm of cardiovascular therapies, leadless pacing has emerged as a promising avenue, offering innovative solutions for patients. However, a recent study aims to fill a crucial knowledge gap by exploring the impact of frailty on the prognosis of individuals undergoing leadless pacemaker implantation. The investigation, based on the National Inpatient Sample from 2017 to 2019, delves into the association between frailty levels and clinical outcomes, shedding light on vital insights for patient care.
This study was published in the journal Heart Rhythm O2 by Carlos D. and colleagues. To assess the association between frailty and clinical outcomes in patients undergoing leadless pacemaker implantation. 16,825 adult patients who underwent leadless pacemaker implantation. Utilized the Hospital Frailty Risk Score, categorized into low, intermediate, and high risk.
The key findings of the study were:
In-Hospital Mortality:
High frailty risk associated with a significant increase in in-hospital mortality (aRR 6.37).
Intermediate frailty risk is also linked to higher in-hospital mortality (aRR 5.15).
Complications:
Similar risk of any complication observed between low, intermediate, and high frailty risk groups.
Frailty did not significantly impact the risk of vascular, pericardial, pneumothorax, infectious, or device-related complications.
Hospital Stay and Charges:
High and intermediate frailty risk correlated with prolonged hospital stay and higher total charges.
Frailty emerged as a robust predictor of resource utilization in leadless pacemaker implantation.
Frailty is prevalent among patients undergoing leadless pacemaker implantation and serves as a pivotal prognostic factor. The study underscores that higher frailty levels significantly increase the risk of in-hospital mortality, extend hospital stays, and escalate associated charges. Notably, frailty did not amplify the risk of specific complications, highlighting its nuanced impact on clinical outcomes in this context.
Reference:
Diaz-Arocutipa, C., Calderon-Ramirez, P. M., Mayta-Tovalino, F., & Torres-Valencia, J. Association between frailty and in-hospital outcomes in patients undergoing leadless pacemaker implantation: a nationwide analysis. Heart Rhythm O2,2023. https://doi.org/10.1016/j.hroo.2023.12.007
