Impact of inter-hospital transfers and admissions to transfer hubs on outcomes of cardiac implantable electronic device-associated infective endocarditis
Authors' conclusion
Direct admissions to hubs and transfers to hubs are associated with higher utilization of TLE. Mortality and complication rates among patients undergoing TLE at hubs and spokes were comparable.
Study context
- Population
- Patients with cardiac implantable electronic device (CIEDs) with a diagnosis of infective endocarditis (IE)
- Participants
- 22,682 admissions
- Exposure
- Direct admissions to hubs and transfers to hubs compared with direct admissions to spokes
- Outcome
- Admission category distribution
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Direct admissions to spokes | Direct admissions to hubs | Transfers to hubs | aOR (95% CI) | |
|---|---|---|---|---|---|
| TLE ratesDirect admissions to hubs vs direct admissions to spokes · TLE | 4.0% | 12.9% | 38.1% | 3.12 (2.55–3.81) | |
| TLE ratesTransfers to hubs vs direct admissions to spokes · TLE | 11.51 (9.28–14.25) | ||||
| 0.050.21520Adjusted odds ratio (log scale) |
- Transvenous lead extraction/removal (TLE) rates: P < .001 across groups for TLE rates
Factors associated with transfer
- Transfers were associated with male sex, Staphylococcus aureus infection, and heart failure
Index and early mortality
- Similar among direct admissions to spokes, direct admissions to hubs, and transfers to hubs
- After adjustment for age and comorbidities
Original publication
Impact of inter-hospital transfers and admissions to transfer hubs on outcomes of cardiac implantable electronic device-associated infective endocarditis. Heart Rhythm. Published 24 July 2025. doi:10.
Summarised from the published abstract; every number is checked against it