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Infections and associated costs following cardiovascular implantable electronic device implantations: a nationwide cohort study.
Clémenty, Nicolas; Carion, Phuong Lien; Léotoing, Lucie de; Lamarsalle, Ludovic; Wilquin-Bequet, Fanny; Brown, Benedict; Verhees, Koen J P; Fernandes, Jérôme; Deharo, Jean-Claude.
Affiliation
  • Clémenty N; Centre Hospitalier Régional Universitaire de Tours, Boulevard Tonnellé, Tours, France.
  • Carion PL; Medtronic France, Quai Alphonse le Gallo 27, Boulogne-Billancourt, France.
  • Léotoing L; HEVA, Health Economics and Outcomes Research, Avenue Thiers 186, Lyon, France.
  • Lamarsalle L; HEVA, Health Economics and Outcomes Research, Avenue Thiers 186, Lyon, France.
  • Wilquin-Bequet F; Medtronic France, Quai Alphonse le Gallo 27, Boulogne-Billancourt, France.
  • Brown B; Medtronic International Trading Sàrl, Route du Molliau 31, Tolochenaz, Switzerland.
  • Verhees KJP; Medtronic, Bakken Research Center (BRC), Endepolsdomein 5, GW, Maastricht, The Netherlands.
  • Fernandes J; OC Santé, Centre Médical Odysseum, Avenue Nina Simone 194, CS, Montpellier, France.
  • Deharo JC; Centre Hospitalier Universitaire (CHU), Hôpital de la Timone, Medical School of Marseille, Department of Cardiology, Rue Saint-Pierre 264, Marseille, France.
Europace ; 20(12): 1974-1980, 2018 12 01.
Article in En | MEDLINE | ID: mdl-29672690
ABSTRACT

Aims:

This study assessed the contemporary occurrence of cardiac device infections (CDIs) following implantation in French hospitals and estimated associated costs. Methods and

Results:

A retrospective analysis was conducted on the French National Hospital Database (PMSI). Patients with a record of de novo cardiac implantable electronic device (CIED) implantation or replacement interventions in France in 2012 were identified and followed until the end of 2015. Cardiac device infections (CDIs) were identified based on coding using the French classification for procedures [Classification Commune des Actes Médicaux (CCAM)] and International Classification of Diseases (ICD-10). Associated costs were estimated based on direct costs from the perspective of the French social security system. In total 78 267 CIED patients (72% de novo implants) were identified (15% defibrillators; 84% pacemakers). The 36-month infection rate associated with de novo defibrillator-only implants, as well as for cardiac resynchronisation therapy - defibrillators (CRT-Ds) was 1.6%. The CDI risk was 2.9% and 3.9% for replacement ICDs and CRT-Ds. Infection rates were lower for de novo single-chamber pacemaker (SCP)/dual-chamber pacemaker (DCP) (0.5%) and cardiac resynchronisation therapy - pacemaker (CRT-P) implants (1.0%), while for replacement procedures the risk increased to 1.4% (SCP/DCP) and 1.3% (CRT-P). Mean infection-related costs over 24 months were €20 623 and €23 234 for CDIs associated with replacement and de novo procedures, and overall costs were not significantly different between pacemaker and defibrillator patients.

Conclusion:

Cardiac device infections in France are associated with substantial costs, when considering inpatient hospitalizations. Strategies to minimize the rate of CIED infection should be a priority for health care providers and payers.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pacemaker, Artificial / Electric Countershock / Cardiac Pacing, Artificial / Prosthesis-Related Infections / Defibrillators, Implantable Type of study: Diagnostic_studies / Etiology_studies / Health_economic_evaluation / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Aged80 / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: En Journal: Europace Journal subject: CARDIOLOGIA / FISIOLOGIA Year: 2018 Document type: Article Affiliation country: France Publication country: ENGLAND / ESCOCIA / GB / GREAT BRITAIN / INGLATERRA / REINO UNIDO / SCOTLAND / UK / UNITED KINGDOM

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pacemaker, Artificial / Electric Countershock / Cardiac Pacing, Artificial / Prosthesis-Related Infections / Defibrillators, Implantable Type of study: Diagnostic_studies / Etiology_studies / Health_economic_evaluation / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Aged80 / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: En Journal: Europace Journal subject: CARDIOLOGIA / FISIOLOGIA Year: 2018 Document type: Article Affiliation country: France Publication country: ENGLAND / ESCOCIA / GB / GREAT BRITAIN / INGLATERRA / REINO UNIDO / SCOTLAND / UK / UNITED KINGDOM