The association of multimorbidity to mortality in older adults after permanent pacemaker placement.

Data No data sharing availability BACKGROUND: In the United States 2018 bradycardia guideline, the current class III recommendation that patients with permanent pacemaker (PPM) indications and high multimorbidity burden may not have meaningful clinical benefit from PPM therapy is based on limited data. Methods Observational study (1/1/2008-12/31/2015) of adults ≥ 65 years (N = 16,678) who underwent PPM implantation. Exposure variable: Elixhauser comorbidity number (ECN, 29 well-validated conditions). Primary outcome ≤ 1-year mortality; secondary outcome: > 1-year mortality. Results Those who died ≤ 1-year were older, had a lower body mass index (BMI), and higher ECN (P 1-year [HR 1.19 (95% CI: 1.17 - 1.20)] mortality. A predictive model including age, sex, BMI, PPM type, race, and ECN had greater discriminative ability (p Conclusion Across the heterogeneity of indications for PPM placement, multimorbidity is increasingly common. The association of multimorbidity to mortality (≤ 1-year, >1-year) should be routinely discussed during the shared decision-making process as an important prognostic geriatric domain variable. This article is protected by copyright. All rights reserved.