Cardiac implantable electronic device infections : Who is at greatest risk?
Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Cardiac implantable electronic device (CIED) infections are associated with hospitalization, mortality, increased costs, and adverse outcomes.
OBJECTIVE: Determine the burden of infections for CIEDs based on device type, associated comorbidities, and clinical characteristics over a 12-year period.
METHODS: Utilizing data from the National Inpatient Sample database for cases from 2000 through 2012, we identified procedures for device-related infection (DRI) using International Statistical Classification of Diseases and Related Health Problems, Ninth Revision, Clinical Modification (ICD-9-CM) codes for CIED removal with diagnosis codes for device-related infection or systemic infection. Cases were categorized into 4 groups: single-chamber pacemaker, dual-chamber pacemaker, cardiac resynchronization therapy (CRT) device, and intracardiac defibrillator (ICD).
RESULTS: Of 4,144,683 device-related procedures, 85,203 (2.06%) were associated with DRI. From 2000 through 2012, procedures related to DRI increased from 1.45% to 3.41% (P < .001). The risk of infection for CRT devices was the highest, peaking in 2012 (adjusted odds ratio [OR] 2.43, P < .001). During second half of the study, comorbidities associated with DRI were diabetes (OR: 1.11, P < .001), end-stage renal disease (OR: 3.23, P < .001), hematoma (OR: 2.44, P < .001), malnutrition (OR: 2.66, P < .001), venous thromboembolism (OR: 2.37, P < .001), chronic kidney disease (OR: 1.26, P < .001), and organ transplantation (OR: 2.37, P < .001). Charges associated with CRT DRIs increased nearly 2-fold in a decade. Higher inpatient mortality related to device infection were stroke (OR: 3.19, P < .001), end-stage renal disease (OR: 2.91, P < .001), malnutrition (OR: 2.67, P < .001), cirrhosis (OR: 2.05, P = .001), and organ transplantation (OR: 2.16, P < .001).
CONCLUSION: CIED infections are increasing for all device types and particularly for CRT devices. Precise reasons for rising DRI procedures remain unclear, although conditions leading to immune compromise appear significant.
| Errataetall: |
CommentIn: Heart Rhythm. 2017 Jun;14 (6):846-847. - PMID 28343911 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
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| Enthalten in: |
Heart rhythm - 14(2017), 6 vom: 15. Juni, Seite 839-845 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Joy, Parijat Saurav [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 21.03.2018 Date Revised 10.12.2019 published: Print-Electronic CommentIn: Heart Rhythm. 2017 Jun;14 (6):846-847. - PMID 28343911 Citation Status MEDLINE |
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| doi: |
10.1016/j.hrthm.2017.03.019 |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Cardiac implantable electronic device infections |b Who is at greatest risk? |
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| 500 | |a CommentIn: Heart Rhythm. 2017 Jun;14 (6):846-847. - PMID 28343911 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Cardiac implantable electronic device (CIED) infections are associated with hospitalization, mortality, increased costs, and adverse outcomes | ||
| 520 | |a OBJECTIVE: Determine the burden of infections for CIEDs based on device type, associated comorbidities, and clinical characteristics over a 12-year period | ||
| 520 | |a METHODS: Utilizing data from the National Inpatient Sample database for cases from 2000 through 2012, we identified procedures for device-related infection (DRI) using International Statistical Classification of Diseases and Related Health Problems, Ninth Revision, Clinical Modification (ICD-9-CM) codes for CIED removal with diagnosis codes for device-related infection or systemic infection. Cases were categorized into 4 groups: single-chamber pacemaker, dual-chamber pacemaker, cardiac resynchronization therapy (CRT) device, and intracardiac defibrillator (ICD) | ||
| 520 | |a RESULTS: Of 4,144,683 device-related procedures, 85,203 (2.06%) were associated with DRI. From 2000 through 2012, procedures related to DRI increased from 1.45% to 3.41% (P < .001). The risk of infection for CRT devices was the highest, peaking in 2012 (adjusted odds ratio [OR] 2.43, P < .001). During second half of the study, comorbidities associated with DRI were diabetes (OR: 1.11, P < .001), end-stage renal disease (OR: 3.23, P < .001), hematoma (OR: 2.44, P < .001), malnutrition (OR: 2.66, P < .001), venous thromboembolism (OR: 2.37, P < .001), chronic kidney disease (OR: 1.26, P < .001), and organ transplantation (OR: 2.37, P < .001). Charges associated with CRT DRIs increased nearly 2-fold in a decade. Higher inpatient mortality related to device infection were stroke (OR: 3.19, P < .001), end-stage renal disease (OR: 2.91, P < .001), malnutrition (OR: 2.67, P < .001), cirrhosis (OR: 2.05, P = .001), and organ transplantation (OR: 2.16, P < .001) | ||
| 520 | |a CONCLUSION: CIED infections are increasing for all device types and particularly for CRT devices. Precise reasons for rising DRI procedures remain unclear, although conditions leading to immune compromise appear significant | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Cardiac resynchronization therapy | |
| 650 | 4 | |a Complications | |
| 650 | 4 | |a Implantable cardioverter-defibrillator | |
| 650 | 4 | |a Infections mortality/survival | |
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| 700 | 1 | |a Olshansky, Brian |e verfasserin |4 aut | |
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