Arrhythmias & electrophysiologyCohort study
Cardiac implantable electronic device implantation and device-related infection
- Retrospective cohort study
- National Inpatient Sample database 2011–2018
Authors' conclusion
Device-related infection is relatively common and continues to be associated with high morbidity and mortality. The prevalence of DRI has not changed significantly despite technical and technological advances in cardiac devices and their implantation.
Study context
- Population
- Admissions for cardiac implantable electronic devices (CIED) implantation and device-related infection, US National Inpatient Sample, 2011–2018
- Participants
- 1,604,173 CIED implantation admissions
- Exposure
- Device-related infections (DRI) vs no DRI among CIED admissions
- DRIn = 71,007
- CIED implantationn = 1,604,173reference
- Outcome
- Trend in CIED implantations and burden and morbidity of DRI
Main finding
As reported in the abstract
DRI admission rate
DRI
4.4%
71 007 of 71 007
- No significant change in annual DRI admission rates (3.96-4.59%)
- P for trend = 0.98
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Predictors of in-hospital mortality with DRI (multivariate) — CHF vs CIED implantation | 1.67 (1.35–2.07) | ||
| Predictors of in-hospital mortality with DRI (multivariate) — End-stage renal disease vs CIED implantation | 1.90 (1.46–2.48) | ||
| Predictors of in-hospital mortality with DRI (multivariate) — Coagulopathy vs CIED implantation | 2.94 (2.40–3.61) | ||
| Predictors of in-hospital mortality with DRI (multivariate) — Malnutrition vs CIED implantation | 2.50 (1.99–3.15) | ||
| 0.20.5125Odds ratio (log scale) |
%
| Outcome | DRI | CIED implantation | Estimate | P value |
|---|---|---|---|---|
| Male sex | 69.3 | Not reported in the abstract | P < 0.001 | |
| Charlson comorbidity index ≥3 | 46.6 | Not reported in the abstract | P < 0.001 |
- In-hospital mortality with DRI (annual)
- 4.4% · mean · range 3.9–5.8%
- In-hospital mortality with DRI (annual) — Trend in annual in-hospital mortality
- P value for trend = 0.07
- Male sex: No DRI 57%
- Charlson comorbidity index ≥3: No DRI 36.8%
In-hospital mortality with DRI (annual)
- Prevalence of congestive heart failure (CHF) increased in DRI admissions over the observation period
Safety
- Most common complications with DRI
- 4.1 · PE · DVT 3.6 · Post-procedural hematoma 2.90%
Original publication
Cardiac implantable electronic device implantation and device-related infection. Europace. Published 11 August 2023. doi:10.1093/europace/euad208
Summarised from the published abstract; every number is checked against it