Advanced Age Affects Mortality Risk After Device Implantation

Higher mortality seen among elderly patients who undergo implantation of cardiac devices
By Lindsey Marcellin
HealthDay Reporter

TUESDAY, April 13 (HealthDay News) -- In-hospital mortality is significantly higher for elderly patients who receive implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT) compared with younger patients, according to a study in the April 12 issue of the Archives of Internal Medicine.

Jason P. Swindle, of the Saint Louis University School of Medicine, and colleagues studied a cohort of 26,887 adults older than 18 years who had heart failure and underwent implantation of a CRT device or ICD in 2004 or 2005.

The median age of the patients was 70 years, and 17.5 percent were aged 80 or older. The researchers found that those aged 80 and older were more likely than younger patients to receive CRT alone. Among patients younger than 80 years, in-hospital mortality was 0.7 percent. Mortality rose to 1.2 percent for those aged 80 to 85, and 2.2 percent among those older than 85. Predictors of higher mortality included an age of at least 80, higher numbers of co-morbidities, use of inotropic medication, and having had a procedural complication.

"Our findings indicate that procedure-related complication rates and in-hospital mortality are elevated in patients with advanced age," the authors write. "Given trends in the demographics of heart failure and the costs of device therapy, additional studies are required to clarify the appropriateness of device implantation in older patients with heart failure, as well as the merits of less invasive options."

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