Procedural Complications and Inpatient Outcomes of Leadless Pacemaker Implantations in Rural Versus Urban Hospitals in the United States

被引：0

作者：

Nguyen, Amanda ^{[1
]}

Khan, Muhammad Zia ^{[2
]}

Sattar, Yasar ^{[2
]}

Alruwaili, Waleed ^{[2
]}

Nassar, Sameh ^{[2
]}

Alhajji, Mohamed ^{[2
]}

Alyami, Bandar ^{[2
]}

Neely, Joseph ^{[1
]}

Asad, Zain Ul Abideen ^{[3
]}

Agarwal, Siddharth ^{[3
]}

Raina, Sameer ^{[4
]}

Balla, Sudarshan ^{[2
]}

Nguyen, Bao ^{[5
]}

Fan, Dali ^{[5
]}

Darden, Douglas ^{[6
]}

Munir, Muhammad Bilal ^{[5
]}

机构：

[1] Univ Calif Davis, Dept Med, Med Ctr, Sacramento, CA USA

[2] West Virginia Univ, Heart & Vasc Inst, Div Cardiol, Morgantown, WV USA

[3] Univ Oklahoma, Div Cardiol, Norman, OK USA

[4] Stanford Univ, Div Cardiol, Stanford, CA USA

[5] Univ Calif Davis, Div Cardiol, Sect Electrophysiol, Sacramento, CA 95616 USA

[6] Kansas City Heart Rhythm Inst, Div Cardiol, Overland Pk, KS USA

来源：

CLINICAL CARDIOLOGY | 2025年 / 48卷 / 03期

关键词：

disparities; leadless pacemakers; outcomes; rural; urban; SOCIOECONOMIC-STATUS; THERAPY; TRENDS;

D O I：

10.1002/clc.70081

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Disparities in invasive cardiovascular care and outcomes in rural and urban hospitals across the United States have been reported. However, studies investigating disparities regarding leadless pacemaker outcomes and complications based on hospital location are lacking. Objective: To evaluate differences in outcomes and complications related to leadless pacemaker implantations among rural and urban hospitals. Methods: The National Inpatient Sample was used to identify patients who underwent leadless pacemaker implantations in the United States from 2016 to 2020. Study endpoints assessed included procedural complications and inpatient outcomes of leadless pacemaker implantations among rural and urban hospitals. Results: From 2016 to 2020, there were a total of 28 340 and 665 leadless pacemaker implantations in urban and rural hospitals, respectively. Baseline characteristics were similar among both groups, with notable exceptions of higher rates of coagulopathies (13.2% vs. 6.8%, p < 0.001) and peripheral vascular disorders (10.4% vs. 4.5%, p < 0.001) among urban patients. After multivariable adjustment for confounding variables, leadless pacemaker placements occurring in rural hospitals had lower odds of major complications (aOR 0.59, 95% CI 0.41-0.86), but increased odds of inpatient mortality (aOR 1.70, 95% CI 1.21-2.40). Overall, rural leadless pacemaker recipients experienced lower rates of discharge to home, as well as lower costs and length of stay. Conclusions: A majority of leadless pacemaker implantations occurred in urban hospitals in the United States. Important differences in outcomes were described based on urban and rural hospital location. Further investigation and policy changes are encouraged to promote improved cardiovascular care and outcomes in rural residents.

引用

页数：8

共 34 条

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