Years of life lost as a measure of premature death among dual‑chamber pacemaker recipients from Małopolska Province

Abstract

Background: Pacemakers have become the standard of care in patients with severe bradycardia and conduction abnormalities. The survival and premature mortality can be assessed using the years of life lost (YLLs).

Aims: The aim of the study was to analyze mortality trends over the period from 1999 to 2015 among patients implanted with a dual‑chamber (DDD) pacemaker who were inhabitants of Małopolska Province.

Methods: This was a retrospective study of records collected from consecutive patients who underwent de novo DDD pacemaker implantation at a single center between 1984 and 2014. Inclusion criteria were residence status in Małopolska Province at the latest follow‑up visit and death between 1999 and 2015. The standard expected years of life lost per death was used to calculate YLLs. Time trends were evaluated with joinpoint models and presented as an average annual percentage change (AAPC).

Results: Among a total of 3932 consecutive patients implanted with a DDD pacemaker, 1211 patients met the inclusion criteria. We noted an increase in the mean age at implant from 70 years in 1999 to 75.5 years in 2015 (AAPC, 0.6%; P < 0.05), the number of years lived after DDD pacemaker implantation from 2.6 years to 8.2 years (AAPC, 7.4%; P < 0.05), and the mean age at death from 72.6 years to 83.8 years (AAPC, 0.89%; P < 0.05). Finally, we observed a reduction of the YLLs per death from 17.4 years in 1999 to 9 years in 2015 (AAPC, –4%; P < 0.05). All trends were significant for both men and women.

Conclusions: In the 17‑year follow‑up, we showed significant changes in analyzed trends, in particular a reduction in the YLLs per death.