Details

Autor(en) / Beteiligte

• Birnie, David H.
• Wang, Jia
• Alings, Marco
• Philippon, François
• Parkash, Ratika
• Manlucu, Jaimie
• Angaran, Paul
• Rinne, Claus
• Coutu, Benoit
• Low, R. Aaron
• Essebag, Vidal
• Morillo, Carlos
• Redfearn, Damian
• Toal, Satish
• Becker, Giuliano
• Degrâce, Michel
• Thibault, Bernard
• Crystal, Eugene
• Tung, Stanley
• LeMaitre, John
• Sultan, Omar
• Bennett, Matthew
• Bashir, Jamil
• Ayala-Paredes, Felix
• Gervais, Philippe
• Rioux, Leon
• Hemels, Martin E.W.
• Bouwels, Leon H.R.
• Exner, Derek V.
• Dorian, Paul
• Connolly, Stuart J.
• Longtin, Yves
• Krahn, Andrew D.

Titel

Risk Factors for Infections Involving Cardiac Implanted Electronic Devices

Ist Teil von

• Journal of the American College of Cardiology, 2019-12, Vol.74 (23), p.2845-2854

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2019

Link zum Volltext

Quelle

Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals

Beschreibungen/Notizen

• Cardiac implantable electronic device infection is a major complication that usually requires device removal. PADIT (Prevention of Arrhythmia Device Infection Trial) was a large cluster crossover trial of conventional versus incremental antibiotics. This study sought to investigate independent predictors of device infection in PADIT and develop a novel infection risk score. In brief, over 4 6-month periods, 28 centers used either conventional or incremental prophylactic antibiotic treatment in all patients. The primary outcome was hospitalization for device infection within 1 year (blinded endpoint adjudication). Multivariable logistic prediction modeling was used to identify the independent predictors and develop a risk score for device infection. The prediction models were internally validated with bootstrap methods. Device procedures were performed in 19,603 patients, and hospitalization for infection occurred in 177 (0.90%) within 1 year of follow-up. The final prediction model identified 5 independent predictors of device infection (prior procedures [P], age [A], depressed renal function [D], immunocompromised [I], and procedure type [T]) with an optimism-corrected C-statistic of 0.704 (95% confidence interval: 0.660 to 0.744). A PADIT risk score ranging from 0 to 15 points classified patients into low (0 to 4), intermediate (5 to 6) and high (≥7) risk groups with rates of hospitalization for infection of 0.51%, 1.42%, and 3.41%, respectively. This study identified 5 independent predictors of device infection and developed a novel infection risk score in the largest cardiac implantable electronic device trial to date, warranting validation in an independent cohort. The 5 independent predictors in the PADIT score are readily adopted into clinical practice. (Prevention of Arrhythmia Device Infection Trial [PADIT Pilot]; NCT01002911) [Display omitted]