Utilization of implantable cardioverter-defibrillators in survivors of cardiac arrest in the United States from 1996 to 2001

Andrew Voigt; Rana Ezzeddine; William Barrington; Ogundu Obiaha-Ngwu; Leonard I Ganz; Barry London; Samir Saba

doi:10.1016/j.jacc.2004.05.053

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Utilization of implantable cardioverter-defibrillators in survivors of cardiac arrest in the United States from 1996 to 2001

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Utilization of implantable cardioverter-defibrillators in survivors of cardiac arrest in the United States from 1996 to 2001

Andrew Voigt, Rana Ezzeddine, William Barrington, Ogundu Obiaha-Ngwu, Leonard I Ganz, Barry London and Samir Saba

Journal of the American College of Cardiology, Vol.44(4), pp.855-858

08/18/2004

DOI: 10.1016/j.jacc.2004.05.053

PMID: 15312871

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Abstract

We analyzed the incidence of implantable cardioverter-defibrillator (ICD) therapy in survivors of cardiac arrest (CA) in the U.S. from 1996 through 2001. Cardiac arrest is a class I indication for ICD therapy. The current patterns of ICD utilization in survivors of CA have not been fully examined. We searched a representative sample of all hospital discharges for patients admitted with the primary diagnosis of CA who survived to hospital discharge. Patients with a concomitant diagnosis of acute myocardial infarction or previous ICD in situ were excluded. From 1996 to 2001, 113,262 patients were admitted for CA. Of those, 63,745 (56.3%) did not survive to hospital discharge. Of the remaining 49,517 patients, 30.7% received an ICD before discharge, with a gradual increase in implantation rates from 1996 (23.6%) to 2001 (46.3%). Using logistic regression for the years 2000 and 2001, patients who were discharged without an ICD were older (odds ratio [OR] 0.93 for every 10-year increase in age, p < 0.001), more likely to be African American (OR 0.19, p < 0.001), and more likely to be admitted to a smaller hospital (OR 2.24 for each additional 100 beds, p < 0.001). These predictors were independent of other co-morbid illnesses. Although they are increasing, the rates of ICD therapy after CA remain very low. There are gross discrepancies by race. At a time when newer indications for ICD implantation are emerging, efforts should be focused on identifying the causes of this underutilization and discrepancies in survivors of CA.

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Title: Subtitle: Utilization of implantable cardioverter-defibrillators in survivors of cardiac arrest in the United States from 1996 to 2001
Creators: Andrew Voigt - Cardiovascular Institute
Rana Ezzeddine - Department of Biostatistics, University of Pittsburgh, Pittsburgh, PennsylvaniaUSA
William Barrington - Cardiovascular Institute
Ogundu Obiaha-Ngwu - Cardiovascular Institute
Leonard I Ganz - Cardiovascular Institute
Barry London - Cardiovascular Institute
Samir Saba - Cardiovascular Institute
Resource Type: Journal article
Publication Details: Journal of the American College of Cardiology, Vol.44(4), pp.855-858
DOI: 10.1016/j.jacc.2004.05.053
PMID: 15312871
NLM abbreviation: J Am Coll Cardiol
ISSN: 0735-1097
eISSN: 1558-3597
Publisher: Elsevier Inc
Language: English
Date published: 08/18/2004
Academic Unit: Molecular Physiology and Biophysics; The University of Iowa Institute for Vision Research; Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984025679202771

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