Impact of haematoma after pacemaker and CRT device implantation on hospitalization costs, length of stay, and mortality: a population-based study

• Published in: Europace (London, England) England), 2015-10, Vol.17 (10), p.1548-1554
• Main Authors: Sridhar, Arun Raghav Mahankali, Yarlagadda, Vivek, Yeruva, Madhu Reddy, Kanmanthareddy, Arun, Vallakati, Ajay, Dawn, Buddhadeb, Lakkireddy, Dhanunjaya
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Cardiac Resynchronization Therapy - economics; Cardiac Resynchronization Therapy Devices - adverse effects; Child; Child, Preschool; Comorbidity; Databases, Factual; Female; Hematoma - epidemiology; Hospital Costs; Hospital Mortality; Humans; Infant; International Classification of Diseases; Length of Stay - economics; Male; Middle Aged; Multivariate Analysis; Postoperative Complications; Regression Analysis; Sex Distribution; United States - epidemiology; Young Adult
• ISSN: 1099-5129; 1532-2092
• DOI: 10.1093/europace/euv075

Pocket haematoma is a common complication following pacemaker implantation. Impact of this complication on post-procedural outcomes has previously not been systematically studied. We sought to identify the incidence of pocket haematoma after a de novo pacemaker and cardiac resynchronization therapy (CRT) device implantation and evaluate its impact on the hospital outcomes using a large all-payer national inpatient database. Data from Nationwide Inpatient Sample 2010 was queried to identify all primary implantations of single chamber, dual chamber pacemakers, and biventricular devices during the year 2010 using the appropriate ICD-9 codes. Patients who experienced a procedure-related haematoma during the hospital stay were identified. Of a total of 78,751 primary pacemaker implantations in the year 2010, 1677 (2.1%) of the implantations were complicated by a pocket haematoma. Higher age groups, more complex pacemaker types (BiV > dual chamber > single chamber), and comorbidities such as congestive heart failure and coagulopathy were associated with an increased risk of pocket haematoma formation post-pacemaker implantation. Patients who developed a pocket haematoma had a longer length of stay (8.7 vs. 4.8 days, P < 0.001), higher hospitalization costs ($48,815 vs. $34,324, P < 0.001) and higher in-hospital mortality (2.0 vs. 0.7%, P < 0.001) compared with patients who did not develop a haematoma. Haematoma is a relatively common complication associated with pacemaker implantation; however, it adversely impacts in-hospital outcomes.