Predictors of Long-Term Infections After Cardiac Implantable Electronic Device Surgery - Utility of Novel PADIT and PACE DRAP Scores

Autor: Aleksander Araszkiewicz, Michał Waśniewski, Przemysław Mitkowski, Wojciech Seniuk, Sylwia Sławek-Szmyt, Maciej Lesiak, Krzysztof Szmyt, Marek Grygier, Lidia Chmielewska-Michalak, Tomasz Smukowski
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Pacemaker
Artificial
Prosthesis-Related Infections
genetic structures
medicine.medical_treatment
Cardiac resynchronization therapy
030204 cardiovascular system & hematology
Risk Assessment
Cardiac Resynchronization Therapy
03 medical and health sciences
0302 clinical medicine
Hematoma
Risk Factors
Area under curve
Medicine
Humans
030212 general & internal medicine
Prospective Studies
Cardiac Surgical Procedures
Aged
Aged
80 and over
Heart Failure
business.industry
Multivariable regression analysis
Incidence (epidemiology)
Incidence
Age Factors
Arrhythmias
Cardiac
General Medicine
Odds ratio
Middle Aged
medicine.disease
Confidence interval
Surgery
Defibrillators
Implantable
Procedure Duration
Female
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: Circulation journal : official journal of the Japanese Circulation Society. 84(10)
ISSN: 1347-4820
Popis: Background Cardiac implantable electronic device-related infections (CDI) are of increasing importance and involve substantial healthcare resources. This study aimed to evaluate potential CDI risk factors and the utility of the novel PADIT and PACE DRAP scores to predict CDI.Methods and Results:The study group included 1,000 consecutive patients undergoing implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy (CRT) surgery. Patients' and procedural characteristics were collected. CDI occurrence was assessed during 1-year follow-up. Moreover, if periprocedural significant pocket hematoma (SPH) occurred, the maximal volume was calculated based on ultrasonographic measurements and ABC/2 formula. The overall incidence of CDI was 1.8%. In the multivariable regression analysis independent CDI risk factors were: age >75 years (odds ratio [OR]: 5.93; 95% confidence interval [CI]: 1.77-19.84), system upgrade procedure (OR: 6.46; CI: 1.94-21.44), procedure duration >1 h (OR: 13.96; CI: 4.40-44.25), presence of SPH (OR: 4.95; CI: 1.62-15.13) and reintervention within 1 month (OR: 16.29; CI: 3.14-84.50). The PACE DRAP score had higher discrimination of CDI incidence (area under curve [AUC] 0.72) as compared with the PADIT score (AUC 0.63). Conclusions We identified 5 independent risk factors of CDI development. Our study also showed that the PACE DRAP score was better able to identify patients at high risk of CDI than the PADIT score.
Databáze: OpenAIRE
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