Sex Differences in Acute Complications of Cardiac Implantable Electronic Devices: Implications for Patient Safety

Background To date, limited population-level studies have examined the impact of sex on the acute complications of cardiac implantable electronic devices ( CIED) , including permanent pacemakers, implantable cardioverter defibrillators, and cardiac resynchronization therapy devices. Methods and Resu...

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Bibliographic Details
Published in:Journal of the American Heart Association 2019-01, Vol.8 (2), p.e010869-e010869
Main Authors: Moore, Katherine, Ganesan, Anand, Labrosciano, Clementine, Heddle, William, McGavigan, Andrew, Hossain, Sadia, Horton, Dennis, Hariharaputhiran, Saranya, Ranasinghe, Isuru
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Arrhythmias, Cardiac - therapy
Australia - epidemiology
Cardiac Resynchronization Therapy Devices - adverse effects
complication
devices for heart failure
Follow-Up Studies
Humans
Incidence
Middle Aged
New Zealand - epidemiology
Original Research
pacemaker
Patient Safety
Postoperative Complications - epidemiology
Retrospective Studies
Risk Assessment - methods
Risk Factors
sex
Sex Distribution
Sex Factors
Survival Rate - trends
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Summary:Background To date, limited population-level studies have examined the impact of sex on the acute complications of cardiac implantable electronic devices ( CIED) , including permanent pacemakers, implantable cardioverter defibrillators, and cardiac resynchronization therapy devices. Methods and Results We studied all patients aged >18 years from 2010 to 2015 who were a resident of Australia or New Zealand, undergoing a new permanent pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization therapy implant. Standardized variables were collected including patient demographic characteristics, primary and secondary diagnoses, procedures performed and discharge status. Diagnoses and procedures were coded as per the International Classification of Diseases, Tenth Revision ( ICD-10) and the Australian Classification of Health Interventions. The primary end point was the incidence of major CIED -related complications in-hospital or within 90 days of discharge, with the effect of sex evaluated using multiple logistic regression. A total of 81 304 new CIED (61 658 permanent pacemakers, 12 097 implantable cardioverter defibrillators, 7574 cardiac resynchronization therapy) implants were included (38% women). Overall, 8.5% of women and 8.0% of men experienced a CIED complication ( P=0.008). Differences between women and men remained significant after adjustment for age, procedural acuity, and comorbidities (odds ratio 1.10, 95% CI: 1.04-1.16, P
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.118.010869