@article {516036,
	title = {Hospice Use Following Implantable Cardioverter-Defibrillator Implantation in Older Patients: Results From the National Cardiovascular Data Registry},
	journal = {Circulation},
	volume = {133},
	number = {21},
	year = {2016},
	month = {2016 May 24},
	pages = {2030-7},
	abstract = {BACKGROUND: Older recipients of implantable cardioverter-defibrillators (ICDs) are at increased risk for short-term mortality in comparison with younger patients. Although hospice use is common among decedents aged >65, its use among older ICD recipients is unknown.

METHODS AND RESULTS: Medicare patients aged >65 matched to data in the National Cardiovascular Data Registry - ICD Registry from January 1, 2006 to March 31, 2010 were eligible for analysis (N=194 969). The proportion of ICD recipients enrolled in hospice, cumulative incidence of hospice admission, and factors associated with time to hospice enrollment were evaluated. Five years after device implantation, 50.9\% of patients were either deceased or in hospice. Among decedents, 36.8\% received hospice services. The cumulative incidence of hospice enrollment, accounting for the competing risk of death, was 4.7\% (95\% confidence interval [CI], 4.6\%-4.8\%) within 1 year and 21.3\% (95\% CI, 20.7\%-21.8\%) at 5 years. Factors most strongly associated with shorter time to hospice enrollment were older age (adjusted hazard ratio, 1.77; 95\% CI, 1.73-1.81), class IV heart failure (versus class I; adjusted hazard ratio, 1.79; 95\% CI, 1.66-1.94); ejection fraction ,
	keywords = {Aged, Aged, 80 and over, Cohort Studies, Databases, Factual, Death, Sudden, Cardiac, Defibrillators, Implantable, Female, Follow-Up Studies, Hospices, Humans, Male, Mortality, Registries},
	issn = {1524-4539},
	doi = {10.1161/CIRCULATIONAHA.115.020677},
	author = {Kramer, Daniel B and Reynolds, Matthew R and Normand, Sharon-Lise and Parzynski, Craig S and Spertus, John A and Mor, Vincent and Mitchell, Susan L}
}
