Sebastian König1,2, Laura Ueberham1,2, Ekkehard Schuler3, Michael Wiedemann4, Christopher Reithmann5, Melchior Seyfarth6, Armin Sause6, Jürgen Tebbenjohanns7, Anja Schade8, Dong-In Shin9, Alexander Staudt10, Udo Zacharzowsky11, René Andrié12, Ulrike Wetzel13, Hans Neuser14, Carsten Wunderlich15, Ralf Kuhlen2,3, Jan G P Tijssen16, Gerhard Hindricks1,2, Andreas Bollmann1,2. 1. Department of Electrophysiology, Heart Center Leipzig - Universital Hospital, Strümpellstraße 39, 04289 Leipzig, Germany. 2. Leipzig Heart Institute, Russenstraße 69a, 04289 Leipzig, Germany. 3. Helios Kliniken GmbH, Friedrichstraße 136, 10117 Berlin, Germany. 4. Department of Cardiology, Helios Hospital Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany. 5. Department of Internal Medicine I, Helios Hospital München West, Steinerweg 5, 81241 München, Germany. 6. Department of Cardiology, Helios University Hospital Wuppertal, Heusnerstraße 40, 42283 Wuppertal, Germany. 7. Department of Cardiology, Helios Hospital Hildesheim, Senator-Braun-Allee 33, 31135 Hildesheim, Germany. 8. Department of Cardiology, Helios Hospital Erfurt, Nordhäuser Straße 74, 99089 Erfurt, Germany. 9. Department of Cardiology, Helios Hospital Krefeld, Lutherplatz 40, 47805 Krefeld, Germany. 10. Department of Cardiology and Angiology, Helios Hospital Schwerin, Wismarische Straße 393-397, 19053 Schwerin, Germany. 11. Department of Cardiology, Helios Hospital Bad Saarow, Pieskower Straße 33, 15526 Bad Saarow, Germany. 12. Department of Cardiology, Helios Hospital Siegburg, Ringstraße 49, 53721 Siegburg, Germany. 13. Department of Cardiology, Helios Hospital Aue, Gartenstraße 6, 08280 Aue, Germany. 14. Department of Internal Medicine II, Helios Hospital Plauen, Röntgenstraße 2, 08529 Plauen, Germany. 15. Department of Internal Medicine II, Helios Hospital Pirna, Struppener Straße 13, 01796 Pirna, Germany. 16. Academic Medical Center - University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
Abstract
Aims: Atrial fibrillation (AFib) and atrial flutter (AFlut) are common arrhythmias with increased use of invasive procedures. A steady re-evaluation of relevant safety endpoints is recommended and both quality management and pay-for-performance programs are evolving. Therefore, the aims of this study were (i) to investigate and report overall in-hospital mortality and mortality of invasive arrhythmia-related procedures and (ii) to identify mortality predictors in a German-wide hospital network. Methods and results: Administrative data provided by 78 Helios hospitals between 2010 and 2017 were examined using International Statistical Classification of Diseases and Related Health Problems- and Operations and Procedures-codes to identify patients with AFib or AFlut as main discharge diagnosis or secondary diagnosis combined with invasive arrhythmia-related interventions. In 161 502 patients, in-hospital mortality was 0.6% with a significant decrease from 0.75% to 0.5% (P < 0.01) during the observational period. In multivariable analysis, age [odds ratio (OR) 2.69, 95% confidence interval (CI) 2.36-3.05; P < 0.01], high centre volume (OR 0.57, 95% CI 0.50-0.65; P < 0.01), emergency hospital admission (OR 1.57, 95% CI 1.38-1.79; P < 0.01), and Charlson Comorbidity Index (CCI, OR 4.95, 95% CI 4.50-5.44; P < 0.01) were found as independent predictors of in-hospital mortality. Mortality rates were 0.05% for left atrial catheter ablation (CA, n = 21 744), 0.3% for right atrial CA (n = 9972), and 0.56% for implantation of a left atrial appendage occluder (n = 2309), respectively. Conclusion: We analysed for the first time in-hospital mortality rates of patients with atrial arrhythmias in a German-wide, multi-centre administrative dataset. This allows feasible, comparable, and up-to-date performance measurement of clinically important endpoints in a real-world setting which may contribute to quality management programs and towards value-based healthcare.
Aims: Atrial fibrillation (AFib) and atrial flutter (AFlut) are common arrhythmias with increased use of invasive procedures. A steady re-evaluation of relevant safety endpoints is recommended and both quality management and pay-for-performance programs are evolving. Therefore, the aims of this study were (i) to investigate and report overall in-hospital mortality and mortality of invasive arrhythmia-related procedures and (ii) to identify mortality predictors in a German-wide hospital network. Methods and results: Administrative data provided by 78 Helios hospitals between 2010 and 2017 were examined using International Statistical Classification of Diseases and Related Health Problems- and Operations and Procedures-codes to identify patients with AFib or AFlut as main discharge diagnosis or secondary diagnosis combined with invasive arrhythmia-related interventions. In 161 502 patients, in-hospital mortality was 0.6% with a significant decrease from 0.75% to 0.5% (P < 0.01) during the observational period. In multivariable analysis, age [odds ratio (OR) 2.69, 95% confidence interval (CI) 2.36-3.05; P < 0.01], high centre volume (OR 0.57, 95% CI 0.50-0.65; P < 0.01), emergency hospital admission (OR 1.57, 95% CI 1.38-1.79; P < 0.01), and Charlson Comorbidity Index (CCI, OR 4.95, 95% CI 4.50-5.44; P < 0.01) were found as independent predictors of in-hospital mortality. Mortality rates were 0.05% for left atrial catheter ablation (CA, n = 21 744), 0.3% for right atrial CA (n = 9972), and 0.56% for implantation of a left atrial appendage occluder (n = 2309), respectively. Conclusion: We analysed for the first time in-hospital mortality rates of patients with atrial arrhythmias in a German-wide, multi-centre administrative dataset. This allows feasible, comparable, and up-to-date performance measurement of clinically important endpoints in a real-world setting which may contribute to quality management programs and towards value-based healthcare.
Authors: Sebastian König; Laura Ueberham; Vincent Pellissier; Sven Hohenstein; Andreas Meier-Hellmann; Holger Thiele; Vusal Ahmadli; Michael A Borger; Ralf Kuhlen; Gerhard Hindricks; Andreas Bollmann Journal: Clin Cardiol Date: 2021-01-26 Impact factor: 3.287
Authors: Charlotte Gibbs; Jacob Thalamus; Doris Tove Kristoffersen; Martin Veel Svendsen; Øystein L Holla; Kristian Heldal; Kristina H Haugaa; Jan Hysing Journal: Europace Date: 2019-08-01 Impact factor: 5.214
Authors: Andreas Bollmann; Sven Hohenstein; Vincent Pellissier; Katharina Stengler; Peter Reichardt; Jörg-Peter Ritz; Holger Thiele; Michael A Borger; Gerhard Hindricks; Andreas Meier-Hellmann; Ralf Kuhlen Journal: PLoS One Date: 2021-03-25 Impact factor: 3.240
Authors: Johannes Leiner; Vincent Pellissier; Sebastian König; Sven Hohenstein; Laura Ueberham; Irit Nachtigall; Andreas Meier-Hellmann; Ralf Kuhlen; Gerhard Hindricks; Andreas Bollmann Journal: Respir Res Date: 2022-09-23
Authors: Andreas Bollmann; Sven Hohenstein; Sebastian König; Andreas Meier-Hellmann; Ralf Kuhlen; Gerhard Hindricks Journal: ESC Heart Fail Date: 2020-09-11