Use of healthcare claims to validate the Prevention of Arrhythmia Device Infection Trial cardiac implantable electronic device infection risk score.

Autor:	Ahmed FZ; Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK., Blomström-Lundqvist C; Department of Medical Science and Cardiology, Uppsala University, Uppsala, Sweden., Bloom H; Deratment of Medicine, Emory University & Director of Electrophysiology, Atlanta VA Medical Center, Atlanta, GA, USA., Cooper C; Infectious Disease Consultants, Altamonte Springs, FL, USA., Ellis C; Cardiac Electrophysiology Vanderbilt Heart and Vascular Institute, Vanderbilt University, Nashville, TN, USA., Goette A; Department of Cardiology and Intensive Care Medicine, St. Vincenz Hospital, Paderborn, Germany., Greenspon AJ; Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Love CJ; Department of Medicine & Director, Cardiac Rhythm Device Services, Johns Hopkins University and Hospital, Baltimore, MD, USA., Johansen JB; Department of Cardiology, Odense University Hospital, Odense, Denmark., Philippon F; Institut Universitaire de Cardiologie et de Pneumologie de Québec (Hôpital Laval), Laval, QC, Canada., Tarakji KG; Section of Electrophysiology and Pacing, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA., Holbrook R; Clinical Research, Cardiac Rhythm & Heart Failure, Medtronic, Mounds View, MN, USA., Sherfesee L; Clinical Research, Cardiac Rhythm & Heart Failure, Medtronic, Mounds View, MN, USA., Xia Y; Clinical Research, Cardiac Rhythm & Heart Failure, Medtronic, Mounds View, MN, USA., Seshadri S; Clinical Research, Cardiac Rhythm & Heart Failure, Medtronic, Mounds View, MN, USA., Lexcen DR; Clinical Research, Cardiac Rhythm & Heart Failure, Medtronic, Mounds View, MN, USA., Krahn AD; Department of Medicine, Division of Cardiology, University of British Columbia, BC, Canada.
Jazyk:	angličtina
Zdroj:	Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2021 Sep 08; Vol. 23 (9), pp. 1446-1455.
DOI:	10.1093/europace/euab028
Abstrakt:	Aim: The Prevention of Arrhythmia Device Infection Trial (PADIT) infection risk score, developed based on a large prospectively collected data set, identified five independent predictors of cardiac implantable electronic device (CIED) infection. We performed an independent validation of the risk score in a data set extracted from U.S. healthcare claims. Methods and Results: Retrospective identification of index CIED procedures among patients aged ≥18 years with at least one record of a CIED procedure between January 2011 and September 2014 in a U.S health claims database. PADIT risk factors and major CIED infections (with system removal, invasive procedure without system removal, or infection-attributable death) were identified through diagnosis and procedure codes. The data set was randomized by PADIT score into Data Set A (60%) and Data Set B (40%). A frailty model allowing multiple procedures per patient was fit using Data Set A, with PADIT score as the only predictor, excluding patients with prior CIED infection. A data set of 54 042 index procedures among 51 623 patients with 574 infections was extracted. Among patients with no history of prior CIED infection, a 1 unit increase in the PADIT score was associated with a relative 28% increase in infection risk. Prior CIED infection was associated with significant incremental predictive value (HR 5.66, P < 0.0001) after adjusting for PADIT score. A Harrell's C-statistic for the PADIT score and history of prior CIED infection was 0.76. Conclusion: The PADIT risk score predicts increased CIED infection risk, identifying higher risk patients that could potentially benefit from targeted interventions to reduce the risk of CIED infection. Prior CIED infection confers incremental predictive value to the PADIT score. (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu