TY - JOUR
T1 - Life expectancy after implantation of a first cardiac permanent pacemaker (1995-2008): A population-based study
AU - Bradshaw, Pamela
AU - Stobie, P.
AU - Knuiman, Matthew
AU - Briffa, Tom
AU - Hobbs, Michael
PY - 2015
Y1 - 2015
N2 - © 2015 Published by Elsevier Ireland Ltd. Introduction: Research suggests that survival among the recipients of a cardiac permanent pacemaker (PPM) matches the age- and sex-matched general population in the absence of cardiovascular disease. We used linked administrative data to examine life expectancy-based outcomes for adults requiring a cardiac PPM. Methods: Population-level hospital admissions data were used to identify all recipients of an initial PPM during 1995-2008. Expected years of additional life remaining at the time of implantation were calculated for each patient from population life tables. Observed years were calculated using linked mortality data to end 2011. Cox regression was used to determine demographic and clinical predictors of survival. Results: In 8757 patients age-adjusted risk of death to 5 years was associated with male sex, higher Charlson Comorbidity Index score (excluding cardiac disease), a history of heart failure, cardiomyopathy or atrial fibrillation and emergency admission. Coronary revascularisation surgery reduced long-term risk. The observed/expected ratio of additional years of life was 0.80 for men and 0.84 for women overall, varying from 0.92 for women without significant comorbidity to 0.40 for patients with the highest Charlson score and cardiomyopathy. The oldest patients (80-99 years) did relatively well, probably reflecting patient selection. Heart disease was the most frequent cause of death. Conclusions: Life expectancy among PPMrecipientswithout significant comorbidity approached that of the general population. Greater non-cardiac comorbidity, heart failure, atrial fibrillation and, in particular, cardiomyopathy, contributedmost to the loss of expected years of life in all age groups. The oldest patients andwomen did relatively well.
AB - © 2015 Published by Elsevier Ireland Ltd. Introduction: Research suggests that survival among the recipients of a cardiac permanent pacemaker (PPM) matches the age- and sex-matched general population in the absence of cardiovascular disease. We used linked administrative data to examine life expectancy-based outcomes for adults requiring a cardiac PPM. Methods: Population-level hospital admissions data were used to identify all recipients of an initial PPM during 1995-2008. Expected years of additional life remaining at the time of implantation were calculated for each patient from population life tables. Observed years were calculated using linked mortality data to end 2011. Cox regression was used to determine demographic and clinical predictors of survival. Results: In 8757 patients age-adjusted risk of death to 5 years was associated with male sex, higher Charlson Comorbidity Index score (excluding cardiac disease), a history of heart failure, cardiomyopathy or atrial fibrillation and emergency admission. Coronary revascularisation surgery reduced long-term risk. The observed/expected ratio of additional years of life was 0.80 for men and 0.84 for women overall, varying from 0.92 for women without significant comorbidity to 0.40 for patients with the highest Charlson score and cardiomyopathy. The oldest patients (80-99 years) did relatively well, probably reflecting patient selection. Heart disease was the most frequent cause of death. Conclusions: Life expectancy among PPMrecipientswithout significant comorbidity approached that of the general population. Greater non-cardiac comorbidity, heart failure, atrial fibrillation and, in particular, cardiomyopathy, contributedmost to the loss of expected years of life in all age groups. The oldest patients andwomen did relatively well.
U2 - 10.1016/j.ijcard.2015.04.099
DO - 10.1016/j.ijcard.2015.04.099
M3 - Article
C2 - 25912118
SN - 0167-5273
VL - 190
SP - 42
EP - 46
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 1
ER -