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. 2022 Oct 15;9(10):354.
doi: 10.3390/jcdd9100354.

Length of Hospitalization-Related Differences and Associated Long-Term Prognosis of Patients with Cardiac Resynchronization Therapy: A Propensity Score-Matched Cohort

Yu Yu  1 , Hao Huang  1 , Sijing Cheng  1 , Yu Deng  1 , Chi Cai  1 , Min Gu  1 , Xuhua Chen  1 , Hongxia Niu  1 , Wei Hua  1
Affiliations

Length of Hospitalization-Related Differences and Associated Long-Term Prognosis of Patients with Cardiac Resynchronization Therapy: A Propensity Score-Matched Cohort

Yu Yu et al. J Cardiovasc Dev Dis. .

Abstract

Previous studies indicated that prolonged lengths of hospitalization (LOH) during cardiac resynchronization therapy (CRT) implantation are associated with poorer physical status and higher in-hospital mortality. However, evidence on the impact of LOH on the long-term prognosis of CRT patients is limited. The purpose of this study was to assess LOH-related prognostic differences in CRT patients. In the propensity score-matched cohort, patients with standard LOH (≤7 days, n = 172) were compared with those with prolonged LOH (>7 days, n = 172) for cardiac function and study outcomes during follow-up. The study outcomes were all-cause death and heart failure (HF) hospitalization. In addition, cardiac function and changes in cardiac function at the follow-up period were used for comparison. At a mean follow-up of 3.36 years, patients with prolonged LOH, as compared with those with standard LOH, were associated with a significantly higher risk of all-cause death (hazard ratio [HR] 1.87, 95% confidence interval [CI] 1.18−2.96, p = 0.007), and a higher risk of HF hospitalization (HR 1.68, 95% CI 1.08−2.63, p = 0.023). Moreover, patients with standard LOH had a more significant improvement in cardiac function and a pronounced reduction in QRS duration during follow-up than those with prolonged LOH. LOH-associated differences were found in the long-term prognosis of CRT patients. Patients with prolonged LOH had a worse prognosis than those with standard LOH.

Keywords: cardiac resynchronization therapy; death; heart failure; lengths of hospitalization; long-term prognosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study Population.
Figure 2
Figure 2
The distribution of propensity scores in the matched cohort.
Figure 3
Figure 3
Comparison of cardiac function and changes in cardiac function during follow-up. Comparison of LVEF at follow-up (A), change in LVEF (B), LVEDD at follow-up (C), change in LVEDD (D), NT-proBNP at follow-up (E), change in NT-proBNP (F), QRS at follow up (G), and change in QRS (H).
Figure 4
Figure 4
Kaplan–Meier survival curves of freedom from all-cause death.
Figure 5
Figure 5
Kaplan–Meier survival curves of freedom from HF hospitalization.
Figure 6
Figure 6
Changes in LOH across surgery years.
See this image and copyright information in PMC

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