Pacemaker implantation safe in nonagenarians

Pacemaker implantation safe in nonagenarians

Pacemaker implantation safe in nonagenarians: Anant Mandawat, Jeptha P Curtis, Aditya Mandawat, Valentine Y Njike and Rachel Lampert [1] retrospectively analyzed the data of over one lakh patients aged more than seventy years who had undergone initial pacemaker implantation between 2004 and 2008. Eleven percent of them were nonagenarians (ninety or more years of age). Compared to septuagenarians (70 – 79 years) nonagenarians were more likely to have moderate or severe comorbidities and more likely to be admitted on an emergency basis. While unadjusted mortality and complication rates in septuagenarians were 0.6% and 5.61%, it was 1.87% and 6.31% in nonagenarians. But multivariable analysis revealed that severe comorbidity was a greater predictor of mortality than increasing age. There was also similar association between severe comorbidity and complications. The length of hospital stay and hospitalization costs were also higher in nonagenarians compared to septuagenarians, as expected. The authors concluded that even though older age predicts poorer outcome, the absolute rates are modest even in nonagenarians and the stronger predictor of poor outcome was comorbidity rather than age.

Reference

  1. Anant Mandawat, Jeptha P Curtis, Aditya Mandawat, Valentine Y Njike, Rachel Lampert. Safety of Pacemaker Implantation in Nonagenarians. An Analysis of the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample. Circulation. 2013 Apr 9;127(14):1453-65, 1465e1-2.