Methods: This is a retrospective review of patients identified from an existing institutional CIEDI database. We compared patients in 3 groups: 1) admissions before existence of HR in 2014 (“pre-HR”), 2) admissions after 2014 to HR (“HR”), and 3) admissions after 2014 but to other services (“post-non-HR”). Variables included hospital and intensive care unit (ICU) LOS; mortality; duration of antibiotics and temporary pacemaker use; and times to consultation of subspecialties, CIED extraction, pocket closure, and new CIED implantation. Chi-square analysis was used to compare categorical variables, Kruskal-Wallis test for continuous variables, and multivariate analysis for adjustment of infection type.
Results: There were a total of 210 CIEDI cases: pre-HR n=102, HR n=48, and post-non-HR n=60. Groups were similar in age, gender, ethnicity, and CIED type. However, there was a significantly higher percent of pulse generator pocket infections (83.3%) admitted to HR as compared to post-non-HR (21.7% pocket, 78.3% systemic, p<0.0001). After adjusting for infection types, HR patients were more likely to have had a surgical consult (OR 7.01, 95% CI 1.56-31.5, p=0.011) and shortened time to pocket closure (-2.21 days, 95% CI -3.33 to -1.09, p<0.001) compared to pre-HR.
Conclusion: CIEDI admissions to HR were predominately generator pocket infections, likely because patients with overt signs of CIEDI were triaged to this service. After adjusting for infection type, the HR service was associated with a significant increase in surgical consultation and decreased time to pocket closure. However, other factors, such as hospitalization costs, LOS, and mortality, were not affected.
E. M. Tan,
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 grant
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. M. 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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