Abstract 18772: Impact of Hematoma After Pacemaker Implantation: An Analysis of a Nationwide Database of 77,074 Patients

Abstract

Introduction: Pocket hematoma is one of the most common complications associated with pacemaker implantation. We sought to identify the incidence of pocket hematoma after a de novo pacemaker implantation and evaluate its impact on the hospital outcomes using a large all-payer national inpatient database. Methods: Data from Nationwide Inpatient Sample 2010 was used to identify all hospitalizations for a pacemaker implantation. All primary implantations of single chamber, dual chamber and biventricular pacemakers during the year 2010 were identified using the appropriate ICD-9 codes. We then identified the patients who experienced a procedure related hematoma during the hospital stay. We then compared the outcomes of the patients with and without a hematoma complication. All analyses were performed using SPSS 20 complex samples using appropriate weights to adjust for the complex sampling design of the national database. Results: Out of a total of 77,074 primary pacemaker implantations in the year 2010, 1677 (2.1%) of the implantations were complicated by a hematoma. Patients with biventricular pacemakers were more likely to develop a hematoma than single or dual chamber pacemakers (2.7% vs 1.5%; p<0.001). No other demographic variables or hospital categories were associated with a hematoma formation. Patients who developed a hematoma had a higher mortality (2.0% vs 0.7%, p<0.001), longer hospital length of stay (8.7 days vs 4.8 days, p<0.001) and higher in-hospital charges ($155,071 vs $108,225, p<0.001) compared to patients who did not develop a hematoma. The adverse outcomes associated with hematoma were noted with all the pacemaker sub-types. Conclusions: Hematoma is an uncommon complication associated with pacemaker implantation and adversely impacts in-hospital outcomes.