Major complications and mortality within 30 days of an electrophysiological procedure at an academic medical center: Implications for developing national standards

Sarah Hussain, Meghan M. Eddy, Liza Moorman, Rohit Malhotra, Andrew E. Darby, Kenneth Bilchick, Pamela Mason, Michael J. Mangrum, John P. Dimarco, John D. Ferguson

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Despite growing attention to performance and quality measures, national standards for reporting of outcomes after all electrophysiology (EP) procedures have not yet been developed. We sought to characterize the incidence and timing of adverse events up to 30 days after EP procedures at a tertiary academic medical center. Methods and Results We prospectively followed all patients undergoing EP procedures between January 2010 and September 2012. All were followed for 30 days postprocedure either in clinic or by telephone. Major complications were defined as events related to the procedure that led to prolongation of hospital stay or readmission, required additional procedural intervention, or resulted in death or significant injury. These were further categorized as intraprocedure, postprocedure, or postdischarge events. Seven EP physicians collectively adjudicated whether complications were directly related to the procedure. A total of 3,213 procedures were performed. Major complications occurred in 2.2% of patients; 49% of these events occurred after discharge. Death occurred in 0.6% of patients; 73% of these deaths were found to be secondary to worsening of the patient's underlying comorbid conditions and unrelated to the procedure. Conclusions When considering national standards for reporting outcomes of all EP procedures, continued follow-up after discharge is important. In our cohort, half of major complications occurring within 30 days occurred after discharge. In addition, three-quarters of deaths within 30 days were not directly related to the procedure and caution should be used in using all-cause mortality as an outcome measure for EP procedures.

Original languageEnglish (US)
Pages (from-to)527-531
Number of pages5
JournalJournal of cardiovascular electrophysiology
Volume26
Issue number5
DOIs
StatePublished - May 1 2015

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Electrophysiology
Mortality
Patient Readmission
Telephone
Length of Stay
Outcome Assessment (Health Care)
Physicians
Incidence
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Hussain, Sarah ; Eddy, Meghan M. ; Moorman, Liza ; Malhotra, Rohit ; Darby, Andrew E. ; Bilchick, Kenneth ; Mason, Pamela ; Mangrum, Michael J. ; Dimarco, John P. ; Ferguson, John D. / Major complications and mortality within 30 days of an electrophysiological procedure at an academic medical center : Implications for developing national standards. In: Journal of cardiovascular electrophysiology. 2015 ; Vol. 26, No. 5. pp. 527-531.
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abstract = "Background Despite growing attention to performance and quality measures, national standards for reporting of outcomes after all electrophysiology (EP) procedures have not yet been developed. We sought to characterize the incidence and timing of adverse events up to 30 days after EP procedures at a tertiary academic medical center. Methods and Results We prospectively followed all patients undergoing EP procedures between January 2010 and September 2012. All were followed for 30 days postprocedure either in clinic or by telephone. Major complications were defined as events related to the procedure that led to prolongation of hospital stay or readmission, required additional procedural intervention, or resulted in death or significant injury. These were further categorized as intraprocedure, postprocedure, or postdischarge events. Seven EP physicians collectively adjudicated whether complications were directly related to the procedure. A total of 3,213 procedures were performed. Major complications occurred in 2.2{\%} of patients; 49{\%} of these events occurred after discharge. Death occurred in 0.6{\%} of patients; 73{\%} of these deaths were found to be secondary to worsening of the patient's underlying comorbid conditions and unrelated to the procedure. Conclusions When considering national standards for reporting outcomes of all EP procedures, continued follow-up after discharge is important. In our cohort, half of major complications occurring within 30 days occurred after discharge. In addition, three-quarters of deaths within 30 days were not directly related to the procedure and caution should be used in using all-cause mortality as an outcome measure for EP procedures.",
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Major complications and mortality within 30 days of an electrophysiological procedure at an academic medical center : Implications for developing national standards. / Hussain, Sarah; Eddy, Meghan M.; Moorman, Liza; Malhotra, Rohit; Darby, Andrew E.; Bilchick, Kenneth; Mason, Pamela; Mangrum, Michael J.; Dimarco, John P.; Ferguson, John D.

In: Journal of cardiovascular electrophysiology, Vol. 26, No. 5, 01.05.2015, p. 527-531.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Major complications and mortality within 30 days of an electrophysiological procedure at an academic medical center

T2 - Implications for developing national standards

AU - Hussain, Sarah

AU - Eddy, Meghan M.

AU - Moorman, Liza

AU - Malhotra, Rohit

AU - Darby, Andrew E.

AU - Bilchick, Kenneth

AU - Mason, Pamela

AU - Mangrum, Michael J.

AU - Dimarco, John P.

AU - Ferguson, John D.

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Background Despite growing attention to performance and quality measures, national standards for reporting of outcomes after all electrophysiology (EP) procedures have not yet been developed. We sought to characterize the incidence and timing of adverse events up to 30 days after EP procedures at a tertiary academic medical center. Methods and Results We prospectively followed all patients undergoing EP procedures between January 2010 and September 2012. All were followed for 30 days postprocedure either in clinic or by telephone. Major complications were defined as events related to the procedure that led to prolongation of hospital stay or readmission, required additional procedural intervention, or resulted in death or significant injury. These were further categorized as intraprocedure, postprocedure, or postdischarge events. Seven EP physicians collectively adjudicated whether complications were directly related to the procedure. A total of 3,213 procedures were performed. Major complications occurred in 2.2% of patients; 49% of these events occurred after discharge. Death occurred in 0.6% of patients; 73% of these deaths were found to be secondary to worsening of the patient's underlying comorbid conditions and unrelated to the procedure. Conclusions When considering national standards for reporting outcomes of all EP procedures, continued follow-up after discharge is important. In our cohort, half of major complications occurring within 30 days occurred after discharge. In addition, three-quarters of deaths within 30 days were not directly related to the procedure and caution should be used in using all-cause mortality as an outcome measure for EP procedures.

AB - Background Despite growing attention to performance and quality measures, national standards for reporting of outcomes after all electrophysiology (EP) procedures have not yet been developed. We sought to characterize the incidence and timing of adverse events up to 30 days after EP procedures at a tertiary academic medical center. Methods and Results We prospectively followed all patients undergoing EP procedures between January 2010 and September 2012. All were followed for 30 days postprocedure either in clinic or by telephone. Major complications were defined as events related to the procedure that led to prolongation of hospital stay or readmission, required additional procedural intervention, or resulted in death or significant injury. These were further categorized as intraprocedure, postprocedure, or postdischarge events. Seven EP physicians collectively adjudicated whether complications were directly related to the procedure. A total of 3,213 procedures were performed. Major complications occurred in 2.2% of patients; 49% of these events occurred after discharge. Death occurred in 0.6% of patients; 73% of these deaths were found to be secondary to worsening of the patient's underlying comorbid conditions and unrelated to the procedure. Conclusions When considering national standards for reporting outcomes of all EP procedures, continued follow-up after discharge is important. In our cohort, half of major complications occurring within 30 days occurred after discharge. In addition, three-quarters of deaths within 30 days were not directly related to the procedure and caution should be used in using all-cause mortality as an outcome measure for EP procedures.

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