Thrombocytopenia and end stage renal disease are key predictors of survival in patients with cardiac implantable electronic device infections.
Aged
Aged, 80 and over
Defibrillators, Implantable
/ adverse effects
Female
Humans
Kidney Failure, Chronic
/ complications
Male
Middle Aged
Pacemaker, Artificial
/ adverse effects
Prosthesis-Related Infections
/ diagnosis
Renal Dialysis
Risk Assessment
Risk Factors
Thrombocytopenia
/ complications
Time Factors
Treatment Outcome
blood culture
cardiac implantable electronic device infection
end stage renal disease
survival
thrombocytopenia
Journal
Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
13
07
2019
revised:
21
10
2019
accepted:
04
11
2019
pubmed:
9
11
2019
medline:
27
10
2020
entrez:
9
11
2019
Statut:
ppublish
Résumé
Cardiac implantable electronic device (CIED) infections are associated with a high mortality. Our aim was to identify key predictors of survival in patients with CIED infections as to be able to detect high-risk patients and possibly affect modifiable factors. In this observational study, we collected data from 277 patients with CIED infections treated in our department between 2001 and 2017; predictors of survival were evaluated. The median time since the last CIED procedure was 0.83 years (interquartile range [IQR]: 0.25-3.01), median time since initial CIED implant was 4.79 years (IQR: 0.90-11.0 years). Survival at 30 days was 94.9% (95% confidence interval [CI]: 92.3-97.5) and survival at 1 year was 80.9% (CI: 76.4-85.7). Age (odds ratio [OR]: 1.05, CI: 1.01-1.09; P = .009), end stage renal disease (ESRD) with dialysis (OR: 5.14, CI: 1.87-14.11; P = .001), positive blood cultures (OR: 2.19, CI: 1.08-4.45; P = .030), and thrombocytopenia (OR: 2.3, CI, 1.03-5.15; P = .042) were identified as predictors of death within 1 year of treatment of CIED infection. Patients with CIED infection with prior ESRD with dialysis or preoperative thrombocytopenia are at an increased risk of 1-year mortality. We suggest that these patients be evaluated critically and resources be allocated to these patients more liberally. A greater understanding of the role of platelets in immunity may improve treatment of advanced infection in the future.
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
70-79Informations de copyright
© 2019 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals, Inc.
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