Abstract 223: Outcomes of Older Patients Receiving Secondary Prevention Implantable Cardioverter Defibrillators: An Analysis From the NCDR ICD Registry

Background: The clinical trials establishing the efficacy of implantable cardioverter defibrillators (ICDs) for secondary prevention of sudden cardiac death enrolled limited numbers of older patients. We sought to assess the morbidity and mortality of older patients receiving ICDs for secondary prevention in contemporary clinical practice. Methods: Using the NCDR ICD Registry, we identified 20,751 Medicare beneficiaries > 65 years old who underwent secondary prevention ICD implantation between 2006 and 2010 in 1027 US hospitals. Using a probabilistic method, eligible subjects were matched to Medicare claims to assess longitudinal outcomes, including death, hospitalization, and skilled nursing facility (SNF) admission over 1 year. Outcomes were evaluated in strata according to age ( 80 years). Results: The mean age of the cohort was 75 years at the time of implantation; 24.1% were 80 (Table). Overall 1-year survival was 87%, with 91% and 82% in ages =80 respectively. Regardless of age, hospitalizations at one year were frequent, ranging from 47% in 80. Early admission to a SNF was much higher for >80 (12%) than for <70 (4%) (p <0.01). Conclusions: In older patients receiving secondary prevention ICDs, 1-year survival was high in all age strata including age >80. However, rates of hospitalization and SNF admission indicate substantial care needs after device implantation. Figure: ![][1] ![][2] [1]: /embed/graphic-1.gif [2]: /embed/graphic-2.gif