Complications of cardiac implantable electronic device placement in public and private hospitals
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Le résumé fourni par la source
BACKGROUND: Few safety data exist comparing clinical outcomes in Australian public and private hospitals. We hypothesised that differences could exist between public and private hospitals due to differences in acuity and patient-level co-morbidities. AIMS: To report comparative complications of cardiac implantable electronic device (CIED) placement in public and private hospitals. METHODS: We conducted an observational cohort study of outcomes of patients aged >18 years from 2010 to 2015 undergoing a new permanent pacemaker (PPM), implantable cardioverter defibrillator (ICD) or cardiac resynchronisation therapy pacemaker or defibrillator (CRT-D/P) implant in NSW and Queensland public and private hospitals. The primary endpoint was major CIED-related complications occurring in-hospital or within 90 days of discharge. The independent effect of hospital sector was determined using multiple logistic regression, adjusting for covariates, including age, sex, co-morbidities and procedural acuity. RESULTS: A total of 32 364 new CIED implants (PPM 23 845, ICD 5361 and CRT-D/P 3158) were included (49% in private hospitals). Overall, 8.0% of private hospital procedures and 9.6% public hospital procedures experienced at least one complication. After adjustment, the overall risk of CIED complications was similar in private and public hospitals (OR: 0.92, 95% CI: 0.84-1.00, P = 0.06). In analysis of individual complications, adjusted all-cause in-hospital mortality was higher in private hospitals, (OR: 1.49, 95% CI: 1.03-2.16, P = 0.036) primarily driven by an excess mortality in acute cases. The adjusted risk of in-hospital generator operation (OR: 0.53, 95% CI: 0.30-0.94, P = 0.03) and post-discharge infection (OR: 0.61, 95% CI: 0.46-0.81, P < 0.001) was lower in private hospitals. CONCLUSIONS: These data identify important similarities and differences in safety outcomes of CIED implantation between Australian public and private hospitals.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Complications of cardiac implantable electronic device placement in public and private hospitals
- Date Crossref
- 01/10/2020
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Flinders University pays non établi dans la noticeUniversité ou école supérieure
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Flinders Medical Centre pays non établi dans la noticeÉtablissement de santé
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Basil Hetzel Institute pays non établi dans la noticeStructure de recherche
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Flinders Private Hospital pays non établi dans la noticeÉtablissement de santé
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ARC Centre of Excellence for Environmental Decisions pays non établi dans la noticeStructure de recherche
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The University of Adelaide Discipline of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Women's and Children's Health Network pays non établi dans la noticeÉtablissement de santé
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Central Adelaide Local Health Network pays non établi dans la noticeÉtablissement de santé
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College of Medicine and Public Health pays non établi dans la noticeUniversité ou école supérieure
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Department of Cardiology pays non établi dans la noticeInstitution
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Health Performance and Policy Research Unit pays non établi dans la noticeStructure de recherche
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Data to Decisions Cooperative Research Centre Adelaide South Australia Australia pays non établi dans la noticeStructure de recherche
Flinders University, Flinders Medical Centre et Basil Hetzel Institute, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.