Cost implications of defibrillator lead failures.
Europace
; 14(8): 1156-60, 2012 Aug.
Article
em En
| MEDLINE
| ID: mdl-22333240
ABSTRACT
AIMS:
The prevalence of lead failures is increasing with a growing population of implantable cardioverter defibrillator (ICD) recipients. The cost of managing defibrillator lead failures requires investigation. METHODS ANDRESULTS:
A retrospective cohort study of patients requiring lead replacement for defibrillator lead failure was performed. Details pertaining to admissions were recorded. The cost per lead replacement was determined. Twenty-three patients {mean age [standard deviation (SD); range] = 56 (17; 18-83) years; 87% male} underwent lead replacement at a mean (SD; range) interval from implant of 3.0 (1.8; 0.9-9.0) years. The median (SD; range) length of hospital stay was 4.5 (8.6; 1-43) days. Procedure-related complications were recorded for three (13%) patients. Thirty days and 1-year mortality were 0 and 4% (1 of 23). The median (SD; range) cost per lead replacement was 7660 (10 964; 1472-39 663). Bed day costs accounted for 54% of overall costs. Extraction of the failed lead by manual traction at time of lead replacement did not significantly increase costs. The median (SD; range) cost of lead replacement was higher in patients receiving a new ICD generator (n= 6), compared with patients retaining existing generators (n= 17) 23 394 (5026; 17 266-31 245) vs. 4470 (9080; 1472-39 663); P= 0.005. The median (SD; range) cost of lead replacement among patients who remained in hospital pending lead replacement (n= 16) was higher than for patients who underwent replacement on an emergent outpatient basis (n= 7) 8508 (11 920; 1472-39 663) vs. 4372 (7256; 1555-20 478); however, this observation was not statistically significant, P= 0.21.CONCLUSIONS:
Defibrillator lead failures incur significant cost and are likely to undermine overall cost effectiveness of ICDs. Cost-effectiveness analyses of device therapy should include costs related to such complications.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Desfibriladores Implantáveis
/
Falha de Equipamento
/
Hospitalização
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article