Outcomes and costs of implantable cardioverter-defibrillators for primary prevention of sudden cardiac death among the elderly

摘要: Background The clinical outcomes and costs of implantable cardioverter-defibrillators (ICDs) used for primary prevention sudden cardiac death in nonexperimental settings are uncertain. Objective purpose this study was to measure the health among a nationally representative cohort elderly, primary-prevention ICD recipients. Methods We collected health-care cost utilization data from all Medicare beneficiaries hospitalized congestive heart failure (CHF) who had received ICDs between October 2003 September 2005 as well propensity-score-matched control CHF during same period. A multivariable Cox proportional hazards model fitted cohort, which comprised 7125 recipients controls followed through December 2005. claims first year inclusive index hospitalization were assess differences costs. Results receipt associated with significant reduction mortality (adjusted hazard ratio=0.62, 95% confidence interval 0.58–0.67). patients higher median hospital 30 days after initial (median difference=$41,542, P Conclusions implantation reduced nonexperimental, patient population CHF. additional substantial but comparable published cost-effectiveness models that have projected be cost-effective.