2023
Variation in hospital use of cardiac resynchronization therapy-defibrillator among eligible patients and association with clinical outcomes
Chui P, Lan Z, Freeman J, Enriquez A, Khera R, Akar J, Masoudi F, Ong E, Curtis J. Variation in hospital use of cardiac resynchronization therapy-defibrillator among eligible patients and association with clinical outcomes. Heart Rhythm 2023, 20: 1000-1008. PMID: 36963741, DOI: 10.1016/j.hrthm.2023.03.022.Peer-Reviewed Original ResearchConceptsEligible patientsICD RegistryCardiac resynchronizationNational Cardiovascular Data Registry ICD RegistryCRT-D implantationCRT-D useHospital-level outcomesStrong guideline recommendationsHospital-level variationPatient-level outcomesIntraclass correlation coefficientQuality improvement effortsHospital mortalityGuideline indicationsReadmission ratesSelect patientsClinical outcomesGuideline recommendationsHospital variationHospital ratesUse of CRTHospital levelHospital usePatientsCase mix
2022
Comparative Safety of Transcatheter LAAO With the First-Generation Watchman and Next-Generation Watchman FLX Devices
Price M, Friedman D, Du C, Wang Y, Lin Z, Curtis J, Freeman J. Comparative Safety of Transcatheter LAAO With the First-Generation Watchman and Next-Generation Watchman FLX Devices. JACC Cardiovascular Interventions 2022, 15: 2115-2123. PMID: 36357014, DOI: 10.1016/j.jcin.2022.09.002.Peer-Reviewed Original ResearchConceptsHospital major adverse eventsMajor adverse eventsWatchman FLXMajor vascular complicationsMajor bleedingPericardial effusionCardiac arrestDevice embolizationVascular complicationsMyocardial infarctionLower ratesSystemic arterial embolismComposite of deathTransient ischemic attackAtrial appendage occlusionSignificant lower rateBalance of risksHospital mortalityIschemic attackArterial embolismHospital outcomesPrimary endpointStroke preventionAdverse eventsProcedural complicationsIn-hospital outcomes and readmission in older adults treated with percutaneous coronary intervention for stable ischemic heart disease
Park DY, Hanna JM, Kadian S, Kadian M, Jones WS, Damluji AA, Kochar A, Curtis JP, Nanna MG. In-hospital outcomes and readmission in older adults treated with percutaneous coronary intervention for stable ischemic heart disease. Journal Of Geriatric Cardiology 2022, 19: 631-642. PMID: 36284680, PMCID: PMC9548058, DOI: 10.11909/j.issn.1671-5411.2022.09.006.Peer-Reviewed Original ResearchStable ischemic heart diseasePercutaneous coronary interventionInpatient percutaneous coronary interventionIschemic heart diseaseHospital mortalityOlder adultsIndex hospitalizationCoronary interventionHospital chargesHeart diseaseNational Readmission DatabaseTotal hospital chargesHigh-risk cohortOlder adult patientsPeriprocedural morbidityCardiovascular causesGastrointestinal hemorrhageHospital lengthHospital outcomesAdult patientsSecondary outcomesLonger LOSPrimary outcomeIntracranial hemorrhageProcedural risk
2021
Comparative outcomes of Riata and Fidelis lead management strategies: Results from the NCDR‐ICD Registry
Zeitler EP, Wang Y, Pokorney SD, Curtis J, Prutkin JM. Comparative outcomes of Riata and Fidelis lead management strategies: Results from the NCDR‐ICD Registry. Pacing And Clinical Electrophysiology 2021, 44: 1897-1906. PMID: 34520564, DOI: 10.1111/pace.14361.Peer-Reviewed Original ResearchConceptsPre-discharge complicationsNCDR ICD RegistryExtraction groupGenerator replacementElective generator changeGenerator replacement proceduresLead dwell timeMedtronic Sprint FidelisPeri-procedural riskOdds of deathLong-term outcomesMulti-centre populationElective generator replacementReal-world populationLead management strategiesHospital complicationsHospital mortalityICD RegistryTerm outcomesSprint FidelisAdjusted ratesComparative outcomesExtraction patientsComplicationsICD leadPredicting In-Hospital Mortality in Patients Undergoing Percutaneous Coronary Intervention
Castro-Dominguez YS, Wang Y, Minges KE, McNamara RL, Spertus JA, Dehmer GJ, Messenger JC, Lavin K, Anderson C, Blankinship K, Mercado N, Clary JM, Osborne AD, Curtis JP, Cavender MA. Predicting In-Hospital Mortality in Patients Undergoing Percutaneous Coronary Intervention. Journal Of The American College Of Cardiology 2021, 78: 216-229. PMID: 33957239, DOI: 10.1016/j.jacc.2021.04.067.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionHospital mortalityQuality improvement effortsCoronary interventionDevelopment cohortValidation cohortRisk-standardized mortality ratesHospital risk-standardized mortality ratesBedside risk scoreHigh-risk patientsIn-Hospital MortalityHospital mortality riskRisk of mortalityLevel of consciousnessProcedural urgencyCathPCI RegistryClinical presentationRisk cohortRisk stratificationCardiovascular instabilityCardiac arrestMortality riskRisk scoreClinical acuityClinical relevance
2020
Revascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018
Khera R, Secemsky EA, Wang Y, Desai NR, Krumholz HM, Maddox TM, Shunk KA, Virani SS, Bhatt DL, Curtis J, Yeh RW. Revascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018. JAMA Internal Medicine 2020, 180: 1317-1327. PMID: 32833024, PMCID: PMC9377424, DOI: 10.1001/jamainternmed.2020.3276.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCohort StudiesCoronary VesselsFemaleFollow-Up StudiesHospital MortalityHumansMaleMiddle AgedMyocardial InfarctionPatient DischargePercutaneous Coronary InterventionRisk AssessmentRisk FactorsShock, CardiogenicST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeUnited StatesConceptsST-segment elevation myocardial infarctionMultivessel percutaneous coronary interventionMultivessel coronary artery diseasePercutaneous coronary interventionAcute myocardial infarctionCoronary artery diseaseCulprit vessel percutaneous coronary interventionCardiogenic shockHospital mortalityArtery diseaseMyocardial infarctionCohort studyPrimary outcomeHospital variationPCI strategyMedicare beneficiariesUnderwent multivessel PCISignificant hospital variationElevation myocardial infarctionSubset of patientsHigh-risk populationRecent evidenceHospital complicationsPCI useRevascularization practiceAssociation of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump With In-Hospital Mortality and Major Bleeding Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock
Dhruva SS, Ross JS, Mortazavi BJ, Hurley NC, Krumholz HM, Curtis JP, Berkowitz A, Masoudi FA, Messenger JC, Parzynski CS, Ngufor C, Girotra S, Amin AP, Shah ND, Desai NR. Association of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump With In-Hospital Mortality and Major Bleeding Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock. JAMA 2020, 323: 734-745. PMID: 32040163, PMCID: PMC7042879, DOI: 10.1001/jama.2020.0254.Peer-Reviewed Original ResearchMeSH KeywordsAgedCause of DeathExtracorporeal Membrane OxygenationFemaleHeart ArrestHeart-Assist DevicesHemorrhageHospital MortalityHumansIntra-Aortic Balloon PumpingMaleMatched-Pair AnalysisMiddle AgedMyocardial InfarctionPercutaneous Coronary InterventionPropensity ScoreRegistriesRetrospective StudiesShock, CardiogenicST Elevation Myocardial InfarctionConceptsMicroaxial left ventricular assist deviceIntra-aortic balloon pumpLeft ventricular assist deviceAcute myocardial infarctionPercutaneous coronary interventionNational Cardiovascular Data RegistryCardiogenic shockHemodynamic supportMyocardial infarctionRegistry-based retrospective cohort studyCardiology-National Cardiovascular Data RegistryChest Pain-MI RegistryST-elevation myocardial infarctionMechanical circulatory support devicesGreater hemodynamic supportHospital major bleedingRetrospective cohort studyPropensity-matched pairsCirculatory support devicesVentricular assist deviceClinical laboratory dataHospital mortalityMajor bleedingHospital deathCohort study
2017
Coronary Venous Dissection from Left Ventricular Lead Placement During Cardiac Resynchronization Therapy With Defibrillator Implantation and Associated in-Hospital Adverse Events (from the NCDR ICD Registry)
Hsu JC, Varosy PD, Bao H, Dewland TA, Curtis JP, Marcus GM. Coronary Venous Dissection from Left Ventricular Lead Placement During Cardiac Resynchronization Therapy With Defibrillator Implantation and Associated in-Hospital Adverse Events (from the NCDR ICD Registry). The American Journal Of Cardiology 2017, 121: 55-61. PMID: 29102348, DOI: 10.1016/j.amjcard.2017.09.019.Peer-Reviewed Original ResearchConceptsCRT-D recipientsVentricular lead placementHospital adverse eventsVenous dissectionMultivariable adjustmentAdverse eventsMajor complicationsLead placementGreater oddsPrevious coronary artery bypass graftImplantable Cardioverter-Defibrillator RegistryLeft ventricular lead placementCoronary artery bypass graftHierarchical multivariable logistic regressionHospital clinical outcomesArtery bypass graftCardiac resynchronization therapyMultivariable logistic regressionBundle branch blockHospital complicationsHospital mortalityHospital deathHospital stayDefibrillator implantationProlonged hospitalizationAge Differences in Hospital Mortality for Acute Myocardial Infarction: Implications for Hospital Profiling.
Dharmarajan K, McNamara RL, Wang Y, Masoudi FA, Ross JS, Spatz EE, Desai NR, de Lemos JA, Fonarow GC, Heidenreich PA, Bhatt DL, Bernheim SM, Slattery LE, Khan YM, Curtis JP. Age Differences in Hospital Mortality for Acute Myocardial Infarction: Implications for Hospital Profiling. Annals Of Internal Medicine 2017, 167: 555-564. PMID: 28973634, PMCID: PMC9359429, DOI: 10.7326/m16-2871.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionOlder patientsYounger patientsMyocardial infarctionAge groupsHospital risk-standardized mortality ratesRetrospective cohort studyHospital mortality rankingsNational Quality ForumHospital mortalityMedian hospitalHospital outcomesCohort studyACTION RegistryAMI mortalityAmerican CollegeMedicare beneficiariesAMI hospitalizationPatientsMortality rateHospitalQuality ForumHospital ValueHospital profilingCarotid Endarterectomy and Carotid Artery Stenting in the US Medicare Population, 1999-2014
Lichtman JH, Jones MR, Leifheit EC, Sheffet AJ, Howard G, Lal BK, Howard VJ, Wang Y, Curtis J, Brott TG. Carotid Endarterectomy and Carotid Artery Stenting in the US Medicare Population, 1999-2014. JAMA 2017, 318: 1035-1046. PMID: 28975306, PMCID: PMC5818799, DOI: 10.1001/jama.2017.12882.Peer-Reviewed Original ResearchConceptsVascular risk factorsCarotid endarterectomyCarotid arteryHospital mortalityCause mortalityRevascularization ratesIschemic strokeMyocardial infarctionRisk factorsMedicare beneficiariesSerial cross-sectional analysisUnderwent carotid arteryNumber of patientsUS national trendsService Medicare beneficiariesCross-sectional analysisSymptomatic patientsSymptomatic statusUnique patientsCarotid stenosisEndarterectomyMedicare inpatientMAIN OUTCOMEMedicare feePatients
2016
Coronary Catheterization and Percutaneous Coronary Intervention in China: 10-Year Results From the China PEACE-Retrospective CathPCI Study
Zheng X, Curtis JP, Hu S, Wang Y, Yang Y, Masoudi FA, Spertus JA, Li X, Li J, Dharmarajan K, Downing NS, Krumholz HM, Jiang L. Coronary Catheterization and Percutaneous Coronary Intervention in China: 10-Year Results From the China PEACE-Retrospective CathPCI Study. JAMA Internal Medicine 2016, 176: 512. PMID: 26974883, PMCID: PMC5459379, DOI: 10.1001/jamainternmed.2016.0166.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngina, UnstableCardiac CatheterizationChinaCoronary Artery DiseaseDrug-Eluting StentsFemaleHospital MortalityHospitals, UrbanHumansLength of StayMaleMedical RecordsMiddle AgedMyocardial InfarctionOdds RatioOutcome Assessment, Health CarePercutaneous Coronary InterventionPostoperative ComplicationsPostoperative HemorrhageQuality of Health CareRetrospective StudiesStentsTime-to-TreatmentConceptsPercutaneous coronary interventionDrug-eluting stentsQuality of careCoronary catheterizationCoronary interventionNonobstructive coronary artery diseasePrimary percutaneous coronary interventionFuture quality improvement initiativesEvidence-based medicationsOutcomes of patientsCoronary artery diseaseClinical observational studyUse of catheterizationQuality improvement initiativesCalendar year 2001Hospital mortalityArtery diseasePatient characteristicsStable patientsTreatment patternsMedian lengthMean agePCI proceduresMedical recordsObservational studyImpact of Glycoprotein IIb/IIIa Inhibitors Use on Outcomes After Lower Extremity Endovascular Interventions From Nationwide Inpatient Sample (2006–2011)
Arora S, Panaich SS, Patel N, Patel NJ, Lahewala S, Thakkar B, Savani C, Jhamnani S, Singh V, Patel N, Patel S, Sonani R, Patel A, Tripathi B, Deshmukh A, Chothani A, Patel J, Bhatt P, Mohamad T, Remetz MS, Curtis JP, Attaran RR, Mena CI, Schreiber T, Grines C, Cleman M, Forrest JK, Badheka AO. Impact of Glycoprotein IIb/IIIa Inhibitors Use on Outcomes After Lower Extremity Endovascular Interventions From Nationwide Inpatient Sample (2006–2011). Catheterization And Cardiovascular Interventions 2016, 88: 605-616. PMID: 26914274, DOI: 10.1002/ccd.26452.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAmputation, SurgicalCross-Sectional StudiesDatabases, FactualDrug CostsEndovascular ProceduresFemaleHospital CostsHospital MortalityHumansLimb SalvageLogistic ModelsLower ExtremityMaleMiddle AgedMultivariate AnalysisOdds RatioPeripheral Arterial DiseasePlatelet Aggregation InhibitorsPlatelet Glycoprotein GPIIb-IIIa ComplexPropensity ScoreRisk FactorsTime FactorsTreatment OutcomeUnited StatesYoung AdultConceptsGlycoprotein IIb/IIIa inhibitorsPeripheral endovascular interventionsHospital mortalityHospitalization costsEndovascular interventionGPI useAmputation rateUtilization Project Nationwide Inpatient Sample databaseTwo-level hierarchical multivariateIIb/IIIa inhibitorsNationwide Inpatient Sample databaseLower amputation ratesPaucity of dataHospital outcomesPostprocedural complicationsSecondary outcomesPropensity matchingStudy cohortHealthcare costsICD-9Multivariate analysisStudy outcomesSample databaseMortalityHierarchical multivariate
2015
Association of Physician Certification in Interventional Cardiology With In-Hospital Outcomes of Percutaneous Coronary Intervention
Fiorilli PN, Minges KE, Herrin J, Messenger JC, Ting HH, Nallamothu BK, Lipner RS, Hess BJ, Holmboe ES, Brennan JJ, Curtis JP. Association of Physician Certification in Interventional Cardiology With In-Hospital Outcomes of Percutaneous Coronary Intervention. Circulation 2015, 132: 1816-1824. PMID: 26384518, PMCID: PMC4641797, DOI: 10.1161/circulationaha.115.017523.Peer-Reviewed Original ResearchConceptsEmergency coronary artery bypassPercutaneous coronary interventionCoronary artery bypassArtery bypassVascular complicationsHospital mortalityEnd pointHospital outcomesCoronary interventionPCI proceduresIn-Hospital OutcomesPrimary end pointSecondary end pointsComposite end pointRisk of bleedingHierarchical multivariable modelInternal Medicine certificationAmerican BoardCathPCI RegistryPatient characteristicsPCI volumeUnadjusted outcomesAdverse outcomesPatient outcomesMultivariable modelState Mandated Public Reporting and Outcomes of Percutaneous Coronary Intervention in the United States
Cavender MA, Joynt KE, Parzynski CS, Resnic FS, Rumsfeld JS, Moscucci M, Masoudi FA, Curtis JP, Peterson ED, Gurm HS. State Mandated Public Reporting and Outcomes of Percutaneous Coronary Intervention in the United States. The American Journal Of Cardiology 2015, 115: 1494-1501. PMID: 25891991, PMCID: PMC6948713, DOI: 10.1016/j.amjcard.2015.02.050.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionHospital mortalityCoronary interventionPublic reportingMost percutaneous coronary interventionsOutcomes of patientsReporting statesMandatory public reportingHealth care qualityCathPCI RegistryHospital readmissionPatient characteristicsMyocardial infarctionPatientsObserved riskCare qualityMortalityOutcomesFurther studiesPotential strategyInterventionUnited StatesRiskDaysReporting
2014
Predictors of an Inadequate Defibrillation Safety Margin at ICD Implantation Insights From the National Cardiovascular Data Registry
Hsu JC, Marcus GM, Al-Khatib SM, Wang Y, Curtis JP, Sood N, Parker MW, Kluger J, Lampert R, Russo AM. Predictors of an Inadequate Defibrillation Safety Margin at ICD Implantation Insights From the National Cardiovascular Data Registry. Journal Of The American College Of Cardiology 2014, 64: 256-264. PMID: 25034061, DOI: 10.1016/j.jacc.2014.01.085.Peer-Reviewed Original ResearchConceptsInadequate defibrillation safety marginDefibrillation safety marginSimple risk scoreAdverse eventsRisk scoreNew York Heart Association functional class IIIImplantable cardioverter defibrillator implantationNational Cardiovascular Data RegistrySecondary prevention indicationFunctional class IIIHospital adverse eventsCardioverter-defibrillator implantationIschemic heart diseaseLogistic regression modelsHospital mortalityPrevention indicationICD recipientsMale sexDefibrillation testingRenal dialysisHeart diseaseBiventricular deviceData registryLower riskGreater odds
2013
Lower Hospital Volume Is Associated With Higher In-Hospital Mortality in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction
Kontos MC, Wang Y, Chaudhry SI, Vetrovec GW, Curtis J, Messenger J. Lower Hospital Volume Is Associated With Higher In-Hospital Mortality in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2013, 6: 659-667. PMID: 24192572, DOI: 10.1161/circoutcomes.113.000233.Peer-Reviewed Original ResearchConceptsPrimary percutaneous coronary interventionPrimary PCIHigh-volume hospitalsLow-volume hospitalsPercutaneous coronary interventionBalloon timeCoronary interventionHospital volumeHigher annual hospital volumeHigher In-Hospital MortalityAnnual hospital volumeLow hospital volumeRoutine coronary stentingIn-Hospital MortalityElevation myocardial infarctionMajority of patientsNew pharmacological agentsHospital mortalityCathPCI RegistryMultivariate adjustmentUnadjusted mortalityCoronary stentingMyocardial infarctionCurrent guidelinesPatient visitsDoor-to-Balloon Time and Mortality among Patients Undergoing Primary PCI
Menees DS, Peterson ED, Wang Y, Curtis JP, Messenger JC, Rumsfeld JS, Gurm HS. Door-to-Balloon Time and Mortality among Patients Undergoing Primary PCI. New England Journal Of Medicine 2013, 369: 901-909. PMID: 24004117, DOI: 10.1056/nejmoa1208200.Peer-Reviewed Original ResearchConceptsPrimary percutaneous coronary interventionPrimary PCIST-segment elevation myocardial infarctionElevation myocardial infarctionBalloon timeHospital mortalityMyocardial infarctionNational quality improvement initiativePercentage of patientsPercutaneous coronary interventionQuality improvement initiativesMedicare data setSignificant overall changeCathPCI RegistryCoronary interventionMedian doorSubgroup analysisCardiac Perforation From Implantable Cardioverter-Defibrillator Lead Placement
Hsu JC, Varosy PD, Bao H, Dewland TA, Curtis JP, Marcus GM. Cardiac Perforation From Implantable Cardioverter-Defibrillator Lead Placement. Circulation Cardiovascular Quality And Outcomes 2013, 6: 582-590. PMID: 24002030, DOI: 10.1161/circoutcomes.113.000299.Peer-Reviewed Original ResearchConceptsPredictors of perforationCardiac perforationICD recipientsMajor complicationsGreater oddsImplantable cardioverter defibrillator lead placementHigher left ventricular ejection fractionFirst-time ICD recipientsLeft ventricular ejection fractionHierarchical multivariable logistic regressionHeart failure classICD lead implantationAssociated adverse eventsVentricular ejection fractionMultivariable logistic regressionLength of stayBundle branch blockCardiac bypass surgeryHospital mortalityHospital deathHospital stayBypass surgeryFeared complicationMultivariable adjustmentAdverse eventsEnhanced Mortality Risk Prediction With a Focus on High-Risk Percutaneous Coronary Intervention Results From 1,208,137 Procedures in the NCDR (National Cardiovascular Data Registry)
Brennan JM, Curtis JP, Dai D, Fitzgerald S, Khandelwal AK, Spertus JA, Rao SV, Singh M, Shaw RE, Ho KK, Krone RJ, Weintraub WS, Weaver WD, Peterson ED, Registry C. Enhanced Mortality Risk Prediction With a Focus on High-Risk Percutaneous Coronary Intervention Results From 1,208,137 Procedures in the NCDR (National Cardiovascular Data Registry). JACC Cardiovascular Interventions 2013, 6: 790-799. PMID: 23968699, DOI: 10.1016/j.jcin.2013.03.020.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCoronary AngiographyCoronary Artery DiseaseDiscriminant AnalysisFemaleHeart ArrestHospital MortalityHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPercutaneous Coronary InterventionRegistriesReproducibility of ResultsRisk AssessmentRisk FactorsShock, CardiogenicTime FactorsTreatment OutcomeUnited StatesConceptsPercutaneous coronary interventionRecent cardiac arrestCardiogenic shockInpatient mortalityCardiac arrestPercutaneous Coronary Intervention ResultsBedside risk scoreMain lesion locationHigh-risk patientsChronic total occlusionHigh clinical riskRisk of deathHospital mortality risk modelPre-specified patient subgroupsMortality risk predictionMortality risk modelData collection formRisk prediction modelPCI riskHospital mortalityProcedural mortalityAngiographic predictorsCoronary interventionRisk patientsClinical stabilitySafety of Pacemaker Implantation in Nonagenarians
Mandawat A, Curtis JP, Mandawat A, Njike VY, Lampert R. Safety of Pacemaker Implantation in Nonagenarians. Circulation 2013, 127: 1453-1465. PMID: 23513066, DOI: 10.1161/circulationaha.113.001434.Peer-Reviewed Original ResearchMeSH KeywordsAge DistributionAgedAged, 80 and overArrhythmias, CardiacComorbidityCross-Sectional StudiesFemaleHealth Care CostsHospital MortalityHumansLength of StayLinear ModelsLogistic ModelsMaleMultivariate AnalysisOutcome and Process Assessment, Health CarePacemaker, ArtificialPredictive Value of TestsUnited StatesConceptsLength of stayYears of ageSevere comorbiditiesPacemaker implantationUtilization Project Nationwide Inpatient SampleInitial pacemaker implantationCase-mix variationMantel-Haenszel testStepwise linear regression modelHospital mortalityUnadjusted mortalityComplication rateMultivariable analysisUnadjusted outcomesInpatient SampleHealthcare costsPatientsComorbiditiesHierarchical logistic modelsStayNonagenariansMortalityAgeOutcomesComplications