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Implantable cardioverter–defibrillator therapy in Australia, 2002–2015

Journal Article


Abstract


  • Objectives. Quantify hospitalisation trends for implantable cardioverter-defibrillator (ICD) procedures and costs.

    Design and setting. Retrospective observational study using Australian hospitalisation procedure data.

    Participants. Patients with an ICD insertion, replacement, adjustment or removal procedure code (2002-2014).

    Main outcome measures. Number of ICD procedures stratified by procedure year, patient age (0-34; 35-69; ≥70 years) and sex. Age-adjusted population procedure rates per 100,000 population. Number of procedures associated with a complication. Estimated annual hospitalisation costs for ICD procedures.

    Results. Between 2002 and 2014, the annual number of ICD procedures increased 2.5-fold (1,844 to 6,504). Across all procedures, patients aged ≥70 years had considerably higher rates than their younger counterparts. For example, in 2014, the ICD replacement rate was 70 times higher for those aged ≥70 years than patients aged 0-34 years (43.9 vs. 0.6/100,000 population). The complication rate decreased from 45% to 19%, due primarily to a coding change. Across all years and procedure types, males underwent the majority of procedures (67-86%). The annual number of removals represented ≥4% of the number of insertions per year. Between 2011 and 2013, the annual cost of ICD hospitalisations increased 7% (A$144,036,822 vs. A$154,555,814) and aggregate costs for these 3 years was A$445,644,566.

    Conclusion. ICD procedures are increasing in Australia across all age groups, particularly for Australians aged ≥70 years. Given these increases, further studies should examine patterns of care associated with ICD therapy, particularly examining patient and/or hospital factors associated with adverse events, such as removals, to better understand and ultimately improve patient outcomes.

UOW Authors


  •   Blanch, Bianca (external author)
  •   Lago, Luise
  •   Sy, Raymond W. (external author)
  •   Harris, Phillip (external author)
  •   Semsarian, Christopher (external author)
  •   Ingles, J (external author)

Publication Date


  • 2018

Citation


  • B. Blanch, L. P. Lago, R. Sy, P. J. Harris, C. Semsarian & J. Ingles, "Implantable cardioverter–defibrillator therapy in Australia, 2002–2015", Medical Journal of Australia 209 3 (2018) 123-129.

Scopus Eid


  • 2-s2.0-85053414354

Ro Metadata Url


  • http://ro.uow.edu.au/ahsri/918

Number Of Pages


  • 6

Start Page


  • 123

End Page


  • 129

Volume


  • 209

Issue


  • 3

Place Of Publication


  • Australia

Abstract


  • Objectives. Quantify hospitalisation trends for implantable cardioverter-defibrillator (ICD) procedures and costs.

    Design and setting. Retrospective observational study using Australian hospitalisation procedure data.

    Participants. Patients with an ICD insertion, replacement, adjustment or removal procedure code (2002-2014).

    Main outcome measures. Number of ICD procedures stratified by procedure year, patient age (0-34; 35-69; ≥70 years) and sex. Age-adjusted population procedure rates per 100,000 population. Number of procedures associated with a complication. Estimated annual hospitalisation costs for ICD procedures.

    Results. Between 2002 and 2014, the annual number of ICD procedures increased 2.5-fold (1,844 to 6,504). Across all procedures, patients aged ≥70 years had considerably higher rates than their younger counterparts. For example, in 2014, the ICD replacement rate was 70 times higher for those aged ≥70 years than patients aged 0-34 years (43.9 vs. 0.6/100,000 population). The complication rate decreased from 45% to 19%, due primarily to a coding change. Across all years and procedure types, males underwent the majority of procedures (67-86%). The annual number of removals represented ≥4% of the number of insertions per year. Between 2011 and 2013, the annual cost of ICD hospitalisations increased 7% (A$144,036,822 vs. A$154,555,814) and aggregate costs for these 3 years was A$445,644,566.

    Conclusion. ICD procedures are increasing in Australia across all age groups, particularly for Australians aged ≥70 years. Given these increases, further studies should examine patterns of care associated with ICD therapy, particularly examining patient and/or hospital factors associated with adverse events, such as removals, to better understand and ultimately improve patient outcomes.

UOW Authors


  •   Blanch, Bianca (external author)
  •   Lago, Luise
  •   Sy, Raymond W. (external author)
  •   Harris, Phillip (external author)
  •   Semsarian, Christopher (external author)
  •   Ingles, J (external author)

Publication Date


  • 2018

Citation


  • B. Blanch, L. P. Lago, R. Sy, P. J. Harris, C. Semsarian & J. Ingles, "Implantable cardioverter–defibrillator therapy in Australia, 2002–2015", Medical Journal of Australia 209 3 (2018) 123-129.

Scopus Eid


  • 2-s2.0-85053414354

Ro Metadata Url


  • http://ro.uow.edu.au/ahsri/918

Number Of Pages


  • 6

Start Page


  • 123

End Page


  • 129

Volume


  • 209

Issue


  • 3

Place Of Publication


  • Australia