105 Exploring postmortem practices for cardiac device interrogation in the UK

Abstract

<h3>Introduction</h3> An estimated 50,000 people are fitted with Cardiac Implantable Electronic Devices (CIED) annually across the United Kingdom(1). Multiple studies have demonstrated postmortem examination of these devices can provide invaluable insights for determination of cause of death. CIED interrogation is also vital to ensure accurate detection of occurrences of device malfunction or therapy failure (2). Nevertheless, postmortem device checks are not currently part of routine care in the UK. <h3>Aim</h3> Our project aims to assess the rate of postmortem device checks, document variations in current practices and explore feasibility of mandating this practice. In total, 173 National Health Service trusts were served Freedom of Information (FOI) requests to provide institution’s post-mortem procedures related to patients with cardiac devices for the last 5 years. Questions include: If trust morgues accepted community deaths and whether a cardiac physiology department is present to facilitate device checks. Moreover, we explored the prevalence of routine post-mortem device checks and the practice of documentation and communication of device data to clinical team. <h3>Results</h3> At 16 days post request, 50 sites (29%) have responded to the FOI request; it is anticipated we will have a response rate of &gt;95% by April 2024. Eight sites have reported not having a mortuary on site. Preliminary findings are as follows: a large majority (86%) of the trusts accept patients who die in inpatient settings as well as the community. Approximately 3% of the deaths involve patients with a CIED. Despite the presence of cardiac physiology departments in 98% of hospitals, routine post-mortem cardiac device checks are performed in just 17%. In total, 12% responded that findings are documented in medical records and 7% stated they would relay the information to the medical team. Furthermore, it was noted that post-mortem device checks are primarily performed only upon specific requests by the clinical team or as part of device deactivation. <h3>Conclusion</h3> The preliminary results of our study have determined that despite a notable percentage of patients with CIEDs passing through mortuaries in the UK, the majority do not have standardised procedures for postmortem device interrogation or for the documentation and communication of findings. We feel this is a significant missed opportunity, as well as a lacking in duty of care. By the time of the BCS annual conference, we anticipate a high response rate due to the legality of FOI response, providing unique and extensive insights into current UK practice. It is imperative that UK cardiologists and national bodies work together to develop a national standard for postmortem device interrogation, to bridge a significant gap in practice. <h3>Conflict of Interest</h3> None

Ähnliche Arbeiten