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Sex differences in outcomes of transvenous lead extraction: insights from National Readmission Database

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

With the growing use of implantable cardiac devices, the need for transvenous lead extraction has increased, which translates to increased procedural volumes. Sex differences in lead extraction outcomes are not well studied.

Objective

The present study aims at evaluating the impact of sex on outcomes of lead extraction.

Methods

We identified 71,754 patients who presented between 2016 and 2019 and underwent transvenous lead extraction. Their clinical data were retrospectively accrued from the National Readmission Database (NRD) using the corresponding diagnosis codes. We compared clinical outcomes between male and female patients. Odds ratios (ORs) for the primary and secondary outcomes were calculated, and multivariable regression analysis was utilized to adjust for confounding variables.

Results

Compared to male patients, female patients had higher in-hospital complications including pneumothorax (OR 1.26, 95% CI (1.07–1.4), P < 0.01), hemopericardium (OR 1.39, 95% CI (1.02–1.88), P = 0.036), injury to superior vena cava and innominate vein requiring repair (OR 1.88, 95% CI (1.14–3.1), P = 0.014; OR 3.4, 95% CI (1.8–6.5), P < 0.01), need for blood transfusion (OR 1.28, 95% CI (1.18–1.38), P < 0.01), and pericardiocentesis (OR 1.6, 95% CI (1.3–2), P < 0.01). Thirty-day readmission was also significantly higher in female patients (OR 1.09, 95% CI (1.02–1.17), P < 0.01). There was no significant difference regarding in-hospital mortality (OR 0.99, 95% CI (0.87–1.14), P = 0.95).

Conclusion

In female patients, lead extraction is associated with worse clinical outcomes and higher 30-day readmission rate.

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Author information

Author notes

  1. Mahmoud Khalil and Muhammad Haisum Maqsood contributed equally to the manuscript.

Authors and Affiliations

  1. Internal Medicine Department, Lincoln Medical and Mental Health Center, New York, NY, USA

    Mahmoud Khalil & Muhammad Haisum Maqsood

  2. Cardiovascular Medicine Department, Tanta University, Tanta, Egypt

    Mahmoud Khalil

  3. Department of Internal Medicine, CHI St. Alexius Health/University of North Dakota, Bismarck, ND, USA

    Ahmed Maraey

  4. Cardiovascular Medicine Department, University of Toledo, Toledo, OH, USA

    Ahmed Elzanaty

  5. Department of Advanced Heart Failure and Transplant Cardiology, Baylor University Medical Center, Dallas, TX, USA

    Ayman Saeyeldin

  6. Cardiovascular Department, Lincoln Medical and Mental Health Center, New York, NY, USA

    Kenneth Ong

  7. Leon H. Charney Division of Cardiology, Cardiac Electrophysiology, NYU Langone Health, New York University School of Medicine, New York City, NY, USA

    Chirag R. Barbhaiya, Larry A. Chinitz, Scott Bernstein & Mohamed Shokr

  8. Northern Light Cardiology, EMMC Heart Care, Eastern Maine Medical Center, Bangor, ME, USA

    Mohamed Shokr

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  1. Mahmoud Khalil
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Correspondence to Mahmoud Khalil.

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Ethical approval

This study does not need review by the institutional review board because of the de-identified nature of the data in the NRD.

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Khalil, M., Maqsood, M.H., Maraey, A. et al. Sex differences in outcomes of transvenous lead extraction: insights from National Readmission Database. J Interv Card Electrophysiol 66, 1375–1382 (2023). https://doi.org/10.1007/s10840-022-01438-z

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  • DOI: https://doi.org/10.1007/s10840-022-01438-z

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