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Incidence of and risk factors for infectious complications in patients with cardiac device implantation

Authors
 Hea Won Ann  ;  Jin Young Ahn  ;  Yong Duk Jeon  ;  In Young Jung  ;  Su Jin Jeong  ;  Boyoung Joung  ;  MoonHyoung Lee  ;  Nam Su Ku  ;  Sang Hoon Han  ;  June Myung Kim  ;  Jun Yong Choi 
Citation
 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, Vol.36 : 9-14, 2015 
Journal Title
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
ISSN
 1201-9712 
Issue Date
2015
MeSH
Adult ; Aged ; Defibrillators, Implantable* ; Device Removal ; Endocarditis, Bacterial/epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Pacemaker, Artificial* ; Prosthesis-Related Infections/epidemiology* ; Reoperation ; Retrospective Studies ; Risk Factors
Keywords
CIED ; CRT ; ICD ; Pacemaker ; infection
Abstract
OBJECTIVES: The use of cardiac implantable electronic device (CIED; pacemakers, implantable cardioverter-defibrillators [ICD], cardiac re-synchronized therapy [CRT]) implantation, one essential treatment for cardiac arrhythmias, is increasing. Infectious complications related to implants are the main reason for device removal and patient morbidity. We sought to identify the incidence of infectious complications among patients with cardiac device implantation and analyze the risk factors for infectious complications.

METHODS: A retrospective analysis was conducted of 1307 patients (61.5±14.2 years-old, 49.6% male) with cardiac device implantation from January 1990 to April 2013. We analyzed the incidence of infectious complications during the follow-up period. To investigate risk factors associated with infectious complications, we conducted a 1:2 matched case-control study of patients with infectious complications and controls without infectious complications who had the same implantation period and physician.

RESULTS: Among 1307 patients, 12 had a confirmed device-related infection: 7 with a pocket infection and 5 with infective endocarditis. Over a total of 9091.9 device-years, the incidence of infectious complications was 1.3/1000 device-years, based on the 12 patients with an infection. ICD (5.1/1000 device-year) had a higher incidence of infectious complications than other cardiac devices, and no infectious complications were observed among patients with CRT implantation. Mean duration from the time of implantation to infection was 2.02±1.65 years. In a multivariate analysis, the number of prior procedures including wound revision or scar revision was an independent risk factor for infectious complications (OR=10.88, 95% CI 1.11->999, p=0.040).

CONCLUSIONS: Infection was a rare complication of cardiac device implantation, but repeated procedures were associated with infectious complications.
Files in This Item:
T201503974.pdf Download
DOI
10.1016/j.ijid.2015.05.011
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, June Myung(김준명)
Ahn, Jin Young(안진영) ORCID logo https://orcid.org/0000-0002-3740-2826
Ann, Hea Won(안혜원)
Lee, Moon-Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Jeon, Yong Duk(전용덕)
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Jung, In Young(정인영)
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141525
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