Cardiac Implanted Electronic Device-Related Infective Endocarditis: Clinical Features, Management, and Outcomes of 80 Consecutive Patients

Autor:	M.P.H. Karen C. Bloch M.D., B S Jesalyn Tate, Spyros A. Kalams, Daniel J. Lenihan, Christopher R. Ellis, William F. Dresen, Michael T. Baker, Lisa A. Mendes, Frank Papa, David H. Kim
Rok vydání:	2014
Předmět:	medicine.medical_specialty business.industry Retrospective cohort study General Medicine Odds ratio medicine.disease_cause medicine.disease Methicillin-resistant Staphylococcus aureus Surgery Interquartile range Infective endocarditis Concomitant Internal medicine medicine Endocarditis Cardiology and Cardiovascular Medicine business Social Security Death Index
Zdroj:	Pacing and Clinical Electrophysiology. 37:978-985
ISSN:	0147-8389
DOI:	10.1111/pace.12452
Popis:	Background The use of cardiac implantable electronic devices (CIEDs) has expanded dramatically over the past decade, but net clinical benefit has been curtailed by increasing infectious complications. In particular, CIED-related infectious endocarditis (IE) is a serious condition with significant morbidity and mortality. Methods We performed a single-center, retrospective study between July 2006 and February 2011 with CIED-related IE, defined by either lead vegetations detected on echocardiography or by fulfilling Duke criteria for definite endocarditis. Clinical parameters and outcomes were detailed by electronic medical record review and vital status was confirmed by the Social Security Death Index. Results Eighty patients (median age 67, interquartile range 56–75, 58 M/22 F) were diagnosed with CIED-related IE. Overall mortality was 36% with a median time to death of 95 days from presentation. Over half (52%) of the deaths were infection related with a median time to death of 29 days. Multivariate analysis showed methicillin-resistant Staphylococcus aureus (MRSA) infection (odds ratio [OR] 0.158; 95% confidence interval [CI], 0.047–0.534; P = .003) and concomitant valve endocarditis (OR 0.141, CI 0.041–0.491, P = .002) independently predicted mortality. Conclusion In this contemporary series, all-cause mortality in patients with CIED-related IE was high with a short time to death from onset of infection. MRSA and concomitant valve infection were the most powerful independent predictors of mortality.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::df55f02469473ce0f24a8757d3f8e511 https://doi.org/10.1111/pace.12452 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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