The BLISTER Score: A Novel, Externally Validated Tool for Predicting Cardiac Implantable Electronic Device Infections, and Its Cost-Utility Implications for Antimicrobial Envelope Use.
cardiac resynchronization therapy
defibrillators
heart failure
infections
quality of life
risk factors
Journal
Circulation. Arrhythmia and electrophysiology
ISSN: 1941-3084
Titre abrégé: Circ Arrhythm Electrophysiol
Pays: United States
ID NLM: 101474365
Informations de publication
Date de publication:
Mar 2024
Mar 2024
Historique:
pubmed:
23
1
2024
medline:
23
1
2024
entrez:
23
1
2024
Statut:
ppublish
Résumé
Antimicrobial envelopes reduce the incidence of cardiac implantable electronic device infections, but their cost restricts routine use in the United Kingdom. Risk scoring could help to identify which patients would most benefit from this technology. A novel risk score (BLISTER [Blood results, Long procedure time, Immunosuppressed, Sixty years old (or younger), Type of procedure, Early re-intervention, Repeat procedure]) was derived from multivariate analysis of factors associated with cardiac implantable electronic device infection. Diagnostic utility was assessed against the existing PADIT score (Prior procedure, Age, Depressed renal function, Immunocompromised, Type of procedure) in both standard and high-risk external validation cohorts, and cost-utility models examined different BLISTER and PADIT score thresholds for TYRX (Medtronic; Minneapolis, MN) antimicrobial envelope allocation. In a derivation cohort (n=7383), cardiac implantable electronic device infection occurred in 59 individuals within 12 months of a procedure (event rate, 0.8%). In addition to the PADIT score constituents, lead extraction (hazard ratio, 3.3 [95% CI, 1.9-6.1]; The BLISTER score (https://qxmd.com/calculate/calculator_876/the-blister-score-for-cied-infection) was a valid predictor of cardiac implantable electronic device infection, and could facilitate cost-effective antimicrobial envelope allocation to high-risk patients.
Sections du résumé
BACKGROUND
UNASSIGNED
Antimicrobial envelopes reduce the incidence of cardiac implantable electronic device infections, but their cost restricts routine use in the United Kingdom. Risk scoring could help to identify which patients would most benefit from this technology.
METHODS
UNASSIGNED
A novel risk score (BLISTER [Blood results, Long procedure time, Immunosuppressed, Sixty years old (or younger), Type of procedure, Early re-intervention, Repeat procedure]) was derived from multivariate analysis of factors associated with cardiac implantable electronic device infection. Diagnostic utility was assessed against the existing PADIT score (Prior procedure, Age, Depressed renal function, Immunocompromised, Type of procedure) in both standard and high-risk external validation cohorts, and cost-utility models examined different BLISTER and PADIT score thresholds for TYRX (Medtronic; Minneapolis, MN) antimicrobial envelope allocation.
RESULTS
UNASSIGNED
In a derivation cohort (n=7383), cardiac implantable electronic device infection occurred in 59 individuals within 12 months of a procedure (event rate, 0.8%). In addition to the PADIT score constituents, lead extraction (hazard ratio, 3.3 [95% CI, 1.9-6.1];
CONCLUSIONS
UNASSIGNED
The BLISTER score (https://qxmd.com/calculate/calculator_876/the-blister-score-for-cied-infection) was a valid predictor of cardiac implantable electronic device infection, and could facilitate cost-effective antimicrobial envelope allocation to high-risk patients.
Identifiants
pubmed: 38258308
doi: 10.1161/CIRCEP.123.012446
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e012446Références
J Clin Med. 2022 Nov 04;11(21):
pubmed: 36362784
Health Serv Res. 2003 Aug;38(4):1103-20
pubmed: 12968819
Circ Arrhythm Electrophysiol. 2020 May;13(5):e008280
pubmed: 32281393
J Antimicrob Chemother. 2015 Feb;70(2):325-59
pubmed: 25355810
Circ Arrhythm Electrophysiol. 2020 Oct;13(10):e008503
pubmed: 32915063
J Pers Med. 2022 Jan 11;12(1):
pubmed: 35055406
Pol Arch Intern Med. 2018 Feb 28;128(2):138-140
pubmed: 29511152
Europace. 2014 Aug;16(8):1218-25
pubmed: 24569572
Europace. 2021 Sep 8;23(9):1446-1455
pubmed: 33755136
Circulation. 2007 Sep 18;116(12):1349-55
pubmed: 17724263
Europace. 2014 Oct;16(10):1490-5
pubmed: 25087154
J Cardiovasc Electrophysiol. 2015 Oct;26(10):1111-6
pubmed: 26222980
JACC Clin Electrophysiol. 2017 Oct;3(10):1158-1167
pubmed: 29759500
J Am Coll Cardiol. 2005 Dec 20;46(12):2311-21
pubmed: 16360064
Heart Rhythm. 2014 Apr;11(4):595-601
pubmed: 24333543
Europace. 2021 Jun 23;23(23 Suppl 4):iv3-iv10
pubmed: 34051086
JACC Clin Electrophysiol. 2019 Sep;5(9):1071-1080
pubmed: 31537337
Int J Cardiol. 2013 Oct 3;168(3):2159-63
pubmed: 23453871
Value Health. 2005 Jan-Feb;8(1):1-2
pubmed: 15841888
Heart Rhythm. 2020 Jul;17(7):1125-1131
pubmed: 32087358
Int J Cardiol. 2020 Sep 15;315:51-56
pubmed: 32291170
Europace. 2019 Jun 1;21(6):900-908
pubmed: 30796456
J Med Econ. 2019 May;22(5):464-470
pubmed: 30744444
Eur Heart J. 2020 Jun 1;41(21):2012-2032
pubmed: 32101604
Pacing Clin Electrophysiol. 2015 Dec;38(12):1456-63
pubmed: 26351247
Mayo Clin Proc. 2008 Jan;83(1):46-53
pubmed: 18174000
J Arrhythm. 2019 Nov 18;36(1):176-179
pubmed: 32071638
Circ J. 2020 Sep 25;84(10):1754-1763
pubmed: 32893235
Health Technol Assess. 2015 Aug;19(65):1-210
pubmed: 26293406
N Engl J Med. 2019 May 16;380(20):1895-1905
pubmed: 30883056
Circ Arrhythm Electrophysiol. 2010 Aug;3(4):413-24; discussion 424
pubmed: 20716723
J Cardiovasc Electrophysiol. 2015 Jul;26(7):783-9
pubmed: 25845917
J Med Econ. 2018 Mar;21(3):294-300
pubmed: 29171319
JACC Clin Electrophysiol. 2017 Jan;3(1):1-9
pubmed: 29759687
J Am Coll Cardiol. 2011 Aug 30;58(10):1001-6
pubmed: 21867833
Pacing Clin Electrophysiol. 2018 May;41(5):495-503
pubmed: 29411401
Value Health. 2021 Jul;24(7):930-938
pubmed: 34243836
J Hosp Infect. 2017 Mar;95(3):286-291
pubmed: 28131641
Europace. 2018 Apr 1;20(4):643-653
pubmed: 29016747
Europace. 2022 Dec 9;24(12):1973-1980
pubmed: 35989511
Europace. 2015 May;17(5):767-77
pubmed: 25926473
J Arrhythm. 2019 Nov 29;36(1):166-173
pubmed: 32071636