{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:35:59Z","timestamp":1782603359672,"version":"3.54.5"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2013,4,9]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Data are scarce on outcomes of pacemaker implantation in nonagenarians (age\u226590 years).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We identified patients &gt;70 years of age (n=115 683) who underwent initial pacemaker implantation in the 2004 to 2008 Healthcare Cost and Utilization Project\u2013Nationwide Inpatient Sample. Outcomes included in-hospital mortality, complications, length of stay, and charges. Unadjusted outcomes were compared using \u03c7\n              <jats:sup>2<\/jats:sup>\n              and Mantel-Haenszel tests. Multivariate hierarchical logistic models and stepwise linear regression models adjusted for case-mix variation and clustering. Eleven percent (12 917) were &gt;90 years of age. Relative to patients aged 70 to 79 years, patients &gt;90 years of age were more likely to have moderate\/severe comorbidity (Charlson score &gt;1; 43.2% versus 40.1%) and less likely to be admitted electively (17.5% versus 29.9%), all\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001. The unadjusted mortality and complication rates in patients aged 70 to 79 years were 0.60% (confidence interval [CI], 0.53\u20130.67%) and 5.61% (CI, 5.40\u20135.82%), respectively, and in patients aged &gt;90 years were 1.87% (CI, 1.63\u20132.11%) and 6.31% (CI, 5.89\u20136.72%). Length of stay and charges in patients aged 70 to 79 years were 3.22 days (CI, 3.20\u20133.24 days) and $38 871 (CI, $38 700\u2013$39 043), and in patients aged &gt;90 years, 4.27 days (CI, 4.25\u20134.30 days) and $41 373 (CI, $41 190\u2013$41 556). Multivariable analysis revealed severe comorbidity (odds ratio, 5.00; 95% CI, 4.05\u20136.17) was a greater predictor of mortality than increasing age (odds ratio, 2.81 per decade; CI, 2.35\u20133.35), all\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001. Similarly, severe comorbidity (Charlson score &gt;5) was more strongly associated with complications, length of stay, and charges than age.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Although increasing age predicts worsening outcomes in the elderly, the absolute rates are modest, even in nonagenarians, and comorbidity is a stronger predictor.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.113.001434","type":"journal-article","created":{"date-parts":[[2013,3,20]],"date-time":"2013-03-20T03:38:55Z","timestamp":1363750735000},"page":"1453-1465","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Safety of Pacemaker Implantation in Nonagenarians"],"prefix":"10.1161","volume":"127","author":[{"given":"Anant","family":"Mandawat","sequence":"first","affiliation":[{"name":"From the Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (A.M., J.P.C., R.L.); Massachusetts General Hospital and Harvard Medical School, Boston, MA (A.M.); Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT (J.P.C.); Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA (A.M.); and Yale-Griffin Prevention Research Center, Yale School of Public Health, Derby, CT (V.Y.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeptha P.","family":"Curtis","sequence":"additional","affiliation":[{"name":"From the Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (A.M., J.P.C., R.L.); Massachusetts General Hospital and Harvard Medical School, Boston, MA (A.M.); Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT (J.P.C.); Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA (A.M.); and Yale-Griffin Prevention Research Center, Yale School of Public Health, Derby, CT (V.Y.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Mandawat","sequence":"additional","affiliation":[{"name":"From the Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (A.M., J.P.C., R.L.); Massachusetts General Hospital and Harvard Medical School, Boston, MA (A.M.); Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT (J.P.C.); Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA (A.M.); and Yale-Griffin Prevention Research Center, Yale School of Public Health, Derby, CT (V.Y.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentine Y.","family":"Njike","sequence":"additional","affiliation":[{"name":"From the Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (A.M., J.P.C., R.L.); Massachusetts General Hospital and Harvard Medical School, Boston, MA (A.M.); Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT (J.P.C.); Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA (A.M.); and Yale-Griffin Prevention Research Center, Yale School of Public Health, Derby, CT (V.Y.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Lampert","sequence":"additional","affiliation":[{"name":"From the Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (A.M., J.P.C., R.L.); Massachusetts General Hospital and Harvard Medical School, Boston, MA (A.M.); Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT (J.P.C.); Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA (A.M.); and Yale-Griffin Prevention Research Center, Yale School of Public Health, Derby, CT (V.Y.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","unstructured":"US Census Bureau. 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