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Cohort study

Association of the Timing and Extent of Cardiac Implantable Electronic Device Infections With Mortality

JAMA CardiolPublished

  • Prospective cohort study
  • multicentre
  • 28 centres in Canada and the Netherlands
Read the original article ↗

Authors' conclusion

Early systemic infections and delayed localized infections are associated with increased mortality, with the highest risk for patients with delayed systemic infections.

Study context

Population
Patients undergoing cardiac implantable electronic device (CIED) procedures, 28 centres in Canada and the Netherlands, 2012–2016177 developed infection
Participants
19,559 patients
Exposure
CIED infection by timing and extent vs no CIED infection
  • Early localizedn = 74
  • Early systemicn = 45
  • Delayed localizedn = 34
  • Delayed systemicn = 23
Outcome
All-cause mortality by timing and extent of CIED infection (time-dependent analysis)

Main finding

As reported in the abstract

All-cause mortality
Each group vs no infectionAdjusted hazard ratio (95% CI)P value
Early localized
0.64(0.20–1.98)
P = 0.43
Early systemic
2.88(1.48–5.61)
P = 0.002
Delayed localized
3.57(1.33–9.57)
P = 0.01
Delayed systemic
9.30(3.82–22.65)
P < 0.001

Observational data: associations, not effects.

Further findings

Cumulative incidence of CIED infection · 3, 6 and 12 months

Within 3 months
0.6%
Within 6 months
0.7%
Within 12 months
0.9%
Infection rate in first 3 months (highest, reducing significantly thereafter)
0.21% per month

Original publication

Association of the Timing and Extent of Cardiac Implantable Electronic Device Infections With Mortality. JAMA Cardiol. Published 1 May 2023. doi:10.1001/jamacardio.2023.0467
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Summarised from the published abstract; every number is checked against it