دورية أكاديمية
Nomogram for predicting 30-day all-cause mortality after transvenous pacemaker and defibrillator lead extraction.
| العنوان: | Nomogram for predicting 30-day all-cause mortality after transvenous pacemaker and defibrillator lead extraction. |
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| المؤلفون: | Brunner MP; Departments of Cardiac Pacing and Electrophysiology., Yu C; Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio., Hussein AA; Departments of Cardiac Pacing and Electrophysiology., Tarakji KG; Departments of Cardiac Pacing and Electrophysiology., Wazni OM; Departments of Cardiac Pacing and Electrophysiology., Kattan MW; Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio., Wilkoff BL; Departments of Cardiac Pacing and Electrophysiology. Electronic address: wilkofb@ccf.org. |
| المصدر: | Heart rhythm [Heart Rhythm] 2015 Dec; Vol. 12 (12), pp. 2381-6. Date of Electronic Publication: 2015 Jul 17. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101200317 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-3871 (Electronic) Linking ISSN: 15475271 NLM ISO Abbreviation: Heart Rhythm Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Elsevier, c2004- |
| مواضيع طبية MeSH: | Clinical Decision-Making* , Defibrillators, Implantable* , Nomograms* , Pacemaker, Artificial*, Arrhythmias, Cardiac/*mortality , Arrhythmias, Cardiac/*therapy , Device Removal/*mortality, Aged ; Equipment Failure ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Risk Factors |
| مستخلص: | Background: For each clinical circumstance, the benefits of transvenous lead extraction (TLE) need to be weighed against the risks. Clinical decision-making tools for predicting mortality after TLE are lacking. Objective: To create a preoperative risk score for prediction of 30-day all-cause mortality after TLE of pacemaker and defibrillator leads. Methods: Consecutive patients undergoing TLE at the Cleveland Clinic between August 1996 and August 2011 were included in the analysis. A risk nomogram for predicting 30-day all-cause mortality was developed using baseline clinical variables and multivariable logistic regression modeling. Discrimination and calibration were assessed by using bootstrapping for internal validation. Continuous data are presented as median (25th, 75th percentile); categorical data are presented as number (percentage). Results: A total of 5521 (4137 [74.9%] pacemaker and 1384 [25.1%] defibrillator) leads were extracted during 2999 TLE procedures (patient age 67.2 [55.2, 76.2] years, 30.2% female). Lead implant duration was 4.7 (2.4, 8.3) years and 2.0 (1.0, 2.0) leads were extracted per procedure. Sixty-seven patients (2.2%) had died by 30 days after TLE. Variables with the highest predictive value for 30-day all-cause mortality included age, body mass index, hemoglobin, end-stage renal disease, left ventricular ejection fraction, New York Heart Association functional class, extraction for infection, number of prior lead extractions performed by the operator, and extraction of a dual-coil defibrillator lead. These variables were used to create a nomogram with a bootstrap-corrected concordance index value of 0.867. Conclusions: Thirty-day all-cause mortality after TLE can be assessed with good discriminative power using readily available clinical information. (Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Extraction; Implantable cardioverter-defibrillator; Lead; Nomogram; Pacemaker; Risk score |
| تواريخ الأحداث: | Date Created: 20150721 Date Completed: 20160914 Latest Revision: 20161222 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1016/j.hrthm.2015.07.024 |
| PMID: | 26190318 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1556-3871 |
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| DOI: | 10.1016/j.hrthm.2015.07.024 |