Heart failure & cardiomyopathies
Variation in hospital use of cardiac resynchronization therapy-defibrillator among eligible patients and association with clinical outcomes
Authors' conclusion
There is a wide variation in the use of CRT-D across hospitals that was not explained by case mix. Hospital-level variation in CRT-D utilization was associated with clinically significant differences in outcomes.
Study context
- Population
- Patients eligible for cardiac resynchronization therapy-defibrillator (CRT-D) by guideline indications, Medicare claims linked with NCDR ICD Registry, 2010–2015
- Participants
- 30,134 patients1,377 hospitals
- Exposure
- Hospital variation in CRT-D utilization and hospital-level outcomes
- Outcome
- Hospital-level variation in outcomes (all-cause mortality, readmissions, cardiac readmissions) attributable to variation in CRT-D use
Methodological detailsmultilevel modeling, linked Medicare claims and NCDR ICD Registry
- Multilevel modeling
- Linked Medicare claims and NCDR ICD Registry
Main finding
As reported in the abstract
- Median rate of CRT-D implantation in guideline-eligible patients (wide variation across hospitals)
- 89%
- Variation in hospital CRT-D utilization attributable to hospital of treatment (after adjustment)
- 74%
- Differences in hospital mortality associated with differences in hospital CRT-D utilization
- 8.76%
- Differences in hospital readmissions associated with differences in hospital CRT-D utilization
- 5.26%
- Differences in hospital cardiac readmission rates associated with differences in hospital CRT-D utilization
- 4.71%
Observational data: associations, not effects.
Original publication
Variation in hospital use of cardiac resynchronization therapy-defibrillator among eligible patients and association with clinical outcomes. Heart Rhythm. Published 22 March 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →