Methods: This is a retrospective review of patients identified from an existing CIEDI institutional database. Provider usage of the CPM was monitored and associated with the corresponding patient based on clinical documentation. We compared CIEDI patients in 3 groups: those hospitalized prior to CPM availability in 2012 (“pre-CPM”), those hospitalized after 2012 but with no documented CPM usage (“post-non-CPM”), and those with CPM usage (“post-CPM”). Variables included hospital and intensive care unit (ICU) LOS; mortality; duration of antibiotics and temporary pacemaker use; and times to consultation of specialty services, CIED extraction, pocket closure, and new CIED implantation. Chi-square analysis was used for categorical variables, and the Kruskal-Wallis test for continuous variables.
Results: There were 210 pre-CPM cases, 46 post-non-CPM, and 54 post-CPM. Cohorts were similar in age, gender, ethnicity, and CIED type. The post-CPM cohort had a statistically significant decrease (p=0.0001) in time to pocket closure (median 3.5 days) after extraction as compared to pre-CPM (5.0 days). No other significant outcomes were found. Median hospital LOS ranged from 11-14 days, and inpatient mortality ranged from 7.1%-8.0%.
Conclusion: The availability of a CPM was associated with the favorable outcome of reduced time to pocket closure after CIED extraction. However, other factors, such as hospitalization costs and mortality, were not affected. The findings from this initial investigation suggest that a prospective analysis that includes an expectation of CPM compliance is reasonable.
D. C. Desimone, None
B. Anderson, None
J. Linderbaum, None
T. De Ziel, None
Z. Li, None
M. R. Sohail, Medtronic: Consultant , Consulting fee and Research support
Spectranetics: Consultant , Consulting fee
Boston Scientific: Consultant , Consulting fee
Y. M. Cha, None
E. Loomis, None
R. Espinosa, None
P. A. Friedman, None
K. Greason, None
H. Schiller, None
A. Virk, None
W. R. Wilson, None
J. Steckelberg, None
L. M. Baddour, UpToDate: Consultant , Licensing agreement or royalty
Massachusetts Medical Society: NEJM Journal Watch Infectious Diseases â Editor-in-Chief , Editor-in-Chief duties
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