September 12th, 2011

Study Finds Risks and Costs Associated with Infection After Device Implantation

A large new study has found significant risks and costs associated with infections following the implantation of CIEDs (cardiovascular implantable electronic devices), including ICDs, CRT-Ds, and pacemakers.

In a paper published in Archives of Internal Medicine, Muhammad Sohail and colleagues analyzed Medicare data from more than 200,000 patients admitted for CIED implantation, replacement, or revision in 2007, including  5817 admissions with infection. Infection was associated with an increase in the rate ratio for admission mortality (4.8- 7.7) and for long-term mortality (1.6-2.1). The researchers noted that about half of the increased long-term mortality occurred after hospital discharge.

Infection was also associated with longer length of stay (RR, 2.5- 4.0) and an increase in hospital costs ($14,360-$16,498). About 40% of the extra cost was due to the need for intensive care. The increases in mortality and cost were greatest in the group of patients who received pacemakers.

In an accompanying commentary, Ronan Margey notes that the rate of infections related to CIED implantation has been accelerating. The study, he writes, “is a warning siren to physicians to be sure ICD implantation is appropriate per professional society guidelines and to monitor patients at risk of developing infection closely and intervene promptly.”

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