Varying implantable cardioverter defibrillator referral patterns from implanting and non-implanting hospitals
Varying implantable cardioverter defibrillator referral patterns from implanting and non-implanting hospitals
Aims
To assess the impact of hospital type on implantable cardioverter defibrillation (ICD) prescription rates.
Methods and results
The Wessex Cardiothoracic Unit is a regional implanting centre serving eight district general hospitals (DGHs). We audited all new ICD implants performed in our institution over 4 years. Hospitals implanting or referring patients elsewhere were excluded. We categorized patients into three different groups depending on local hospital type—regional centre (one hospital), DGH with a device specialist (one hospital), DGH without a device specialist (two hospitals). For each hospital type, we assessed the overall implant rate based on local population. There were 459 new ICD implants; of which 381 were included in the analysis. Implant rates were higher in areas whose local hospital was a regional centre (103/million/year), when compared with DGHs with (49/million/year) or without a device specialist (48/million/year). This disparity was greatest with respect to coronary artery disease primary prevention indications—implant rates 29, 14, and 9/million/year, respectively.
Conclusions
ICD implant rates are affected by hospital type and are significantly higher in regional centres when compared with DGHs. To increase ICD implant rates, the widespread implementation of clinical pathways to identify prospective primary prevention patients may be needed.
implantable cardioverter defibrillators, sudden cardiac death
1048-1051
Scott, Paul A.
5a16b1f4-74d3-473f-9eeb-c2a823d690dc
Turner, Nicholas G.
8d9c8ecf-730c-4974-9c7a-88ceff007080
Chungh, Aman
8f6ab764-8839-4795-8625-efc7d414182a
Morgan, John M.
ac98099e-241d-4551-bc98-709f6dfc8680
Roberts, Paul R.
193431e8-f9d5-48d6-8f62-ed9052b2571d
2009
Scott, Paul A.
5a16b1f4-74d3-473f-9eeb-c2a823d690dc
Turner, Nicholas G.
8d9c8ecf-730c-4974-9c7a-88ceff007080
Chungh, Aman
8f6ab764-8839-4795-8625-efc7d414182a
Morgan, John M.
ac98099e-241d-4551-bc98-709f6dfc8680
Roberts, Paul R.
193431e8-f9d5-48d6-8f62-ed9052b2571d
Scott, Paul A., Turner, Nicholas G., Chungh, Aman, Morgan, John M. and Roberts, Paul R.
(2009)
Varying implantable cardioverter defibrillator referral patterns from implanting and non-implanting hospitals.
Europace, 11 (8), .
(doi:10.1093/europace/eup145).
Abstract
Aims
To assess the impact of hospital type on implantable cardioverter defibrillation (ICD) prescription rates.
Methods and results
The Wessex Cardiothoracic Unit is a regional implanting centre serving eight district general hospitals (DGHs). We audited all new ICD implants performed in our institution over 4 years. Hospitals implanting or referring patients elsewhere were excluded. We categorized patients into three different groups depending on local hospital type—regional centre (one hospital), DGH with a device specialist (one hospital), DGH without a device specialist (two hospitals). For each hospital type, we assessed the overall implant rate based on local population. There were 459 new ICD implants; of which 381 were included in the analysis. Implant rates were higher in areas whose local hospital was a regional centre (103/million/year), when compared with DGHs with (49/million/year) or without a device specialist (48/million/year). This disparity was greatest with respect to coronary artery disease primary prevention indications—implant rates 29, 14, and 9/million/year, respectively.
Conclusions
ICD implant rates are affected by hospital type and are significantly higher in regional centres when compared with DGHs. To increase ICD implant rates, the widespread implementation of clinical pathways to identify prospective primary prevention patients may be needed.
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Published date: 2009
Keywords:
implantable cardioverter defibrillators, sudden cardiac death
Identifiers
Local EPrints ID: 151115
URI: http://eprints.soton.ac.uk/id/eprint/151115
ISSN: 1099-5129
PURE UUID: 43a05e1c-ea09-405d-9cbe-671d205e6e54
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Date deposited: 07 May 2010 12:46
Last modified: 14 Mar 2024 01:19
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Contributors
Author:
Paul A. Scott
Author:
Nicholas G. Turner
Author:
Aman Chungh
Author:
John M. Morgan
Author:
Paul R. Roberts
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