Low Occurrence of Infections and Death in a Real-World Cohort of Patients with Cardiac Implantable Electronic Devices.
J Clin Med
; 12(7)2023 Mar 30.
Article
en En
| MEDLINE
| ID: mdl-37048682
ABSTRACT
BACKGROUND:
The incidence of infections and death in patients implanted with cardiac implantable electronic devices (CIEDs) is not fully known yet.AIM:
To describe the incidence of CIED-related infection and death, and their potential predictors in a contemporary cohort of CIED patients.METHODS:
All consecutive patients implanted with a CIED at our institution were prospectively enrolled. Follow-up visits were performed 2 weeks after CIED implantation for all patients, and then every 6 months for implantable cardioverter defibrillator (ICD)/cardiac resynchronization therapy (CRT) patients and every 12 months for pacemaker (PM) patients. The adjudication of CIED-related infections was performed by two independent investigators and potential disagreement was resolved by a senior investigator.RESULTS:
Between September 2016 and August 2020, a total of 838 patients were enrolled (34.6% female; median age 77 (69.6-83.6); median PADIT score 2 (2-4)). PMs were implanted in 569 (68%) patients and ICD/CRT in 269 (32%) patients. All patients had pre-implant antibiotic prophylaxis and 5.5% had an antibiotic-eluting envelope. Follow-up data were available for 832 (99.2%) patients. After a median follow-up of 42.3 (30.2-56.4) months, five (0.6%) patients had a CIED-related infection and 212 (25.5%) patients died. Using multivariate Cox regression analysis, end-stage chronic kidney disease (CKD) requiring dialysis and therapy with corticosteroids was independently associated with a higher risk of infection (hazard ratio (HR) 14.20; 95% confidence interval (CI) 1.48-136.62 and HR 14.71; 95% CI 1.53-141.53, respectively). Age (HR 1.07; 95% CI 1.05-1.09), end-stage CKD requiring dialysis (HR 6.13; 95% CI 3.38-11.13) and history of atrial fibrillation (HR 1.47; 95% CI 1.12-1.94) were independently associated with all-cause death.CONCLUSIONS:
In a contemporary cohort of CIED patients, mortality was substantially high and associated with clinical factors depicting a population at risk. On the other hand, the incidence of CIED-related infections was low.
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Bases de datos:
MEDLINE
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Clin Med
Año:
2023
Tipo del documento:
Article
País de afiliación:
Italia