NCDR Study Shows Patients With Low BMI More Likely to Experience ICD Implantation Complications

Underweight, first-time implantable cardioverter-defibrillator (ICD) recipients are more likely to experience periprocedural complications, prolonged hospital stays, and in-hospital death compared with other patients who do not suffer from low body mass index (BMI), according to a study released Oct. 30 in the Journal of the American Heart Association.

The study, which consisted of 83,312 first-time ICD recipients who were selected from the NCDR's® ICD Registry™, found that a higher number of underweight patients experienced complications (normal weight, 2.3 percent; obese, 2.1 percent; underweight, 5.2 percent; P<0.0001) and death (normal weight, 0.3 percent; obese, 0.3 percent; underweight, 0.8 percent; P<0.026) as a result of ICD implantation. The study also showed that after multivariable adjustment, underweight ICD recipients had greater odds of complications (odds ratio [OR], 2.15; 95 percent confidence interval [CI], 1.68 to 2.75; P<0.0001), hospital stays greater than three days (OR, 1.62; 95 percent CI, 1.38 to 1.89; P<0.0001), and in-hospital death (OR, 2.27; 95 percent CI, 1.21 to 4.27; P=0.011) in comparison to patients of a normal weight.

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"The obesity epidemic in the U.S. has prompted increased interest in health outcomes in overweight and obese patients," said Jonathan Hsu, MD, Division of Cardiology, Department of Medicine, University of California, San Francisco, and lead author of the study. "To our knowledge, this is the first study to specifically examine the association of BMI with in-hospital outcomes in ICD recipients."

According to the study authors, the results demonstrate that underweight patients have a greater risk of adverse events when compared with normal weight or obese patients. "These findings may help to inform physicians and patients concerning the risks of ICD implantation in patients of different body size and highlight specific complications that future efforts can target to mitigate risks in underweight patients," they said.

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