Nomogram for predicting 30-day all-cause mortality after transvenous pacemaker and defibrillator lead extraction

摘要: Background For each clinical circumstance, the benefits of transvenous lead extraction (TLE) need to be weighed against risks. Clinical decision-making tools for predicting mortality after TLE are lacking. Objective To create a preoperative risk score prediction 30-day all-cause pacemaker and defibrillator leads. Methods Consecutive patients undergoing at Cleveland Clinic between August 1996 2011 were included in analysis. A nomogram was developed using baseline variables multivariable logistic regression modeling. Discrimination calibration assessed by bootstrapping internal validation. Continuous data presented as median (25th, 75th percentile); categorical number (percentage). Results total 5521 (4137 [74.9%] 1384 [25.1%] defibrillator) leads extracted during 2999 procedures (patient age 67.2 [55.2, 76.2] years, 30.2% female). Lead implant duration 4.7 (2.4, 8.3) years 2.0 (1.0, 2.0) per procedure. Sixty-seven (2.2%) had died 30 days TLE. Variables with highest predictive value age, body mass index, hemoglobin, end-stage renal disease, left ventricular ejection fraction, New York Heart Association functional class, infection, prior extractions performed operator, dual-coil lead. These used bootstrap-corrected concordance index 0.867. Conclusions Thirty-day can good discriminative power readily available information.