Implantable cardioverter defibrillators and permanent pacemakers: prevalence and patient outcomes after trauma

Maria S. Altieri; Ibrahim Almasry; Tyler Jones; Christa McPhee; Jane E McCormack; Emily C Huang; Patricia A Eckardt; Marc J. Shapiro; Sarah Eckardt; James A Vosswinkel; Randeep S. Jawa

doi:10.1016/j.amjsurg.2016.07.013

Implantable cardioverter defibrillators and permanent pacemakers: prevalence and patient outcomes after trauma

Maria S. Altieri
, Ibrahim Almasry
, Tyler Jones
, Christa McPhee
, Jane E McCormack
, Emily C Huang
, Patricia A Eckardt
, Marc J. Shapiro
, Sarah Eckardt
, James A Vosswinkel
, Randeep S. Jawa

Nursing

Stony Brook University

Research & Scholarship: Contribution to journal › Article › peer-review

Abstract

 Background
 The prevalence and outcomes of older trauma patients with implantable cardioverter defibrillators (ICDs) or permanent pacemakers (PPMs) is unknown.
 Methods
 The trauma registry at a regional trauma center was reviewed for blunt trauma patients, aged ≥ 60 years, admitted between 2007 and 2014. Medical records of cardiac devices patients were reviewed.
 Results
 Of 4,193 admissions, there were 146 ICD, 233 PPM, and 3,814 no device patients; median Injury Severity Score was 9. Most cardiac device patients had substantial underlying heart disease. Patients with ICDs (13.0%) and PPMs (8.6%) had higher mortality rates than no device patients (5.6%,    P   = .0002). Among cardiac device patients who died, the device was functioning properly in all that were interrogated; the most common cause of death was intracranial hemorrhage. On propensity score analysis, cardiac devices were not independent predictors of mortality but rather surrogate variables associated with other predictors of mortality.
 Conclusions
 Approximately 9.0% of admitted older patients had cardiac devices. Their presence identified patients who had higher mortality rates, likely because of their underlying comorbidities, including cardiac dysfunction.

Original language	American English
Journal	AJS, The American Journal of Surgery
Volume	212
DOIs	https://doi.org/10.1016/j.amjsurg.2016.07.013
State	Published - 2016

Keywords

ICD
pacemaker
trauma
implantable cardiac device

Disciplines

Medicine and Health Sciences
Nursing

Access to Document

10.1016/j.amjsurg.2016.07.013

Cite this

Altieri, M. S., Almasry, I., Jones, T., McPhee, C., McCormack, J. E., Huang, E. C., Eckardt, P. A., Shapiro, M. J., Eckardt, S., Vosswinkel, J. A., & Jawa, R. S. (2016). Implantable cardioverter defibrillators and permanent pacemakers: prevalence and patient outcomes after trauma. AJS, The American Journal of Surgery, 212. https://doi.org/10.1016/j.amjsurg.2016.07.013

@article{29f8b63a0ee94a52ad534c15998a7d38,

title = "Implantable cardioverter defibrillators and permanent pacemakers: prevalence and patient outcomes after trauma",

abstract = " Background The prevalence and outcomes of older trauma patients with implantable cardioverter defibrillators (ICDs) or permanent pacemakers (PPMs) is unknown. Methods The trauma registry at a regional trauma center was reviewed for blunt trauma patients, aged ≥ 60 years, admitted between 2007 and 2014. Medical records of cardiac devices patients were reviewed. Results Of 4,193 admissions, there were 146 ICD, 233 PPM, and 3,814 no device patients; median Injury Severity Score was 9. Most cardiac device patients had substantial underlying heart disease. Patients with ICDs (13.0\%) and PPMs (8.6\%) had higher mortality rates than no device patients (5.6\%, P = .0002). Among cardiac device patients who died, the device was functioning properly in all that were interrogated; the most common cause of death was intracranial hemorrhage. On propensity score analysis, cardiac devices were not independent predictors of mortality but rather surrogate variables associated with other predictors of mortality. Conclusions Approximately 9.0\% of admitted older patients had cardiac devices. Their presence identified patients who had higher mortality rates, likely because of their underlying comorbidities, including cardiac dysfunction.",

keywords = "ICD, pacemaker, trauma, implantable cardiac device",

author = "Altieri, \{Maria S.\} and Ibrahim Almasry and Tyler Jones and Christa McPhee and McCormack, \{Jane E\} and Huang, \{Emily C\} and Eckardt, \{Patricia A\} and Shapiro, \{Marc J.\} and Sarah Eckardt and Vosswinkel, \{James A\} and Jawa, \{Randeep S.\}",

year = "2016",

doi = "10.1016/j.amjsurg.2016.07.013",

language = "American English",

volume = "212",

journal = "AJS, The American Journal of Surgery",

issn = "1879-1883",

publisher = "Elsevier",

}

TY - JOUR

T1 - Implantable cardioverter defibrillators and permanent pacemakers: prevalence and patient outcomes after trauma

AU - Altieri, Maria S.

AU - Almasry, Ibrahim

AU - Jones, Tyler

AU - McPhee, Christa

AU - McCormack, Jane E

AU - Huang, Emily C

AU - Eckardt, Patricia A

AU - Shapiro, Marc J.

AU - Eckardt, Sarah

AU - Vosswinkel, James A

AU - Jawa, Randeep S.

PY - 2016

Y1 - 2016

N2 - Background The prevalence and outcomes of older trauma patients with implantable cardioverter defibrillators (ICDs) or permanent pacemakers (PPMs) is unknown. Methods The trauma registry at a regional trauma center was reviewed for blunt trauma patients, aged ≥ 60 years, admitted between 2007 and 2014. Medical records of cardiac devices patients were reviewed. Results Of 4,193 admissions, there were 146 ICD, 233 PPM, and 3,814 no device patients; median Injury Severity Score was 9. Most cardiac device patients had substantial underlying heart disease. Patients with ICDs (13.0%) and PPMs (8.6%) had higher mortality rates than no device patients (5.6%, P = .0002). Among cardiac device patients who died, the device was functioning properly in all that were interrogated; the most common cause of death was intracranial hemorrhage. On propensity score analysis, cardiac devices were not independent predictors of mortality but rather surrogate variables associated with other predictors of mortality. Conclusions Approximately 9.0% of admitted older patients had cardiac devices. Their presence identified patients who had higher mortality rates, likely because of their underlying comorbidities, including cardiac dysfunction.

AB - Background The prevalence and outcomes of older trauma patients with implantable cardioverter defibrillators (ICDs) or permanent pacemakers (PPMs) is unknown. Methods The trauma registry at a regional trauma center was reviewed for blunt trauma patients, aged ≥ 60 years, admitted between 2007 and 2014. Medical records of cardiac devices patients were reviewed. Results Of 4,193 admissions, there were 146 ICD, 233 PPM, and 3,814 no device patients; median Injury Severity Score was 9. Most cardiac device patients had substantial underlying heart disease. Patients with ICDs (13.0%) and PPMs (8.6%) had higher mortality rates than no device patients (5.6%, P = .0002). Among cardiac device patients who died, the device was functioning properly in all that were interrogated; the most common cause of death was intracranial hemorrhage. On propensity score analysis, cardiac devices were not independent predictors of mortality but rather surrogate variables associated with other predictors of mortality. Conclusions Approximately 9.0% of admitted older patients had cardiac devices. Their presence identified patients who had higher mortality rates, likely because of their underlying comorbidities, including cardiac dysfunction.

KW - ICD

KW - pacemaker

KW - trauma

KW - implantable cardiac device

U2 - 10.1016/j.amjsurg.2016.07.013

DO - 10.1016/j.amjsurg.2016.07.013

M3 - Article

SN - 1879-1883

VL - 212

JO - AJS, The American Journal of Surgery

JF - AJS, The American Journal of Surgery

ER -