Prognosis after pacemaker implantation in extreme elderly

Significant comorbidities may limit the potential benefit of pacemaker (PM) implantation in extreme elderly. A short-term mortality risk prediction score, able to identify high-risk patients, may be a useful tool in this population. We retrospectively analyzed 538 patients aged >80 years at the t...

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Bibliographic Details
Published in:European journal of internal medicine 2019-07, Vol.65, p.37-43
Main Authors: Balla, Cristina, Malagu’, Michele, Fabbian, Fabio, Guarino, Matteo, Zaraket, Fatima, Brieda, Alessandro, Smarrazzo, Vittorio, Ferrari, Roberto, Bertini, Matteo
Format: Article
Language:English
Subjects:
Complications
Geriatrics
Mortality
Pacemaker
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Summary:Significant comorbidities may limit the potential benefit of pacemaker (PM) implantation in extreme elderly. A short-term mortality risk prediction score, able to identify high-risk patients, may be a useful tool in this population. We retrospectively analyzed 538 patients aged >80 years at the time of implant who underwent PM implantation. Kaplan-Meier survival and multivariable Cox regression analyses were performed to identify patient, procedural or complication variables predictive of death. The ACP (Aging in Cardiac Pacing) Score was constructed by assigning weighted values to the variables identified by hazard ratios, combined into an additive mortality risk score equation. One, two and three-year overall mortality rate was 11%, 21% and 32% respectively. Renal failure (HR 1.63; CI 1.15–2.31; p = .006), active neoplasia (HR 1.78; CI 1.27–2.51; p = .008), connective tissue disorder (3.07; CI 1.34–7.08; p = .048), cerebrovascular disease (HR 1.75; CI 1.25–2.46; p = .001) and the use of a single lead device (HR 2.27; CI 1.6–3.24; p 
ISSN:0953-6205
1879-0828
DOI:10.1016/j.ejim.2019.04.020