PMID- 26351247
OWN - NLM
STAT- MEDLINE
DCOM- 20170110
LR  - 20170111
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 38
IP  - 12
DP  - 2015 Dec
TI  - Differences of Mortality Rates between Pocket and Nonpocket Cardiovascular 
      Implantable Electronic Device Infections.
PG  - 1456-63
LID - 10.1111/pace.12748 [doi]
AB  - BACKGROUND: A steady rise in the use of cardiovascular implantable electronic 
      devices (CIEDs), particularly in the elderly, has led to an increase in 
      device-related infections. Although often studied and reported as a single 
      entity, these complications in fact comprise a heterogeneous group. Specific 
      subgroups may be associated with distinct mortality risks. METHODS: Medical 
      records of all patients who underwent device extraction for CIED-related 
      infection at a single tertiary referral center between 1991 and 2007 were 
      reviewed. Infections were divided into four subgroups: primary pocket site 
      infection (PPSI), pocket site infection with bacteremia, primary/isolated 
      bacteremia (PIB), and device-related infective endocarditis (DRIE). Clinical 
      presentation, laboratory data, and mortality rates were obtained by chart review 
      and by querying the Social Security Death Index. RESULTS: A total of 387 cases 
      were analyzed. The overall in-hospital and 1-year all-cause mortality rates were 
      7.2% and 25.3%, respectively. Patients with PIB or DRIE had significantly higher 
      mortality rates (hazard ratio [HR] 2.3; 95% confidence interval [CI] 1.2-4.6 and 
      HR 2.5; 95% CI 1.6-4.1, respectively) when compared with patients in the PPSI 
      group. Patients who did not receive a new device during the initial admission 
      also had a higher 1-year mortality rate compared to those who did (HR 2.7; 95% CI 
      1.8-4.1). CONCLUSIONS: Our patients with CIED-related infections requiring 
      extraction/hospitalization had a significant mortality risk. Presence of pocket 
      site infection carried a more favorable prognosis, regardless of the presence of 
      bacteremia. Early detection and prevention of CIED-related infections with PIB 
      (i.e., no pocket site involvement), especially for high-risk populations, is 
      needed.
CI  - (c)2015 Wiley Periodicals, Inc.
FAU - Lee, Dong Heun
AU  - Lee DH
AD  - Division of Infectious Diseases and HIV Medicine, Department of Medicine, Drexel 
      University College of Medicine, Philadelphia, Pennsylvania.
FAU - Gracely, Edward J
AU  - Gracely EJ
AD  - Department of Epidemiology and Biostatistics, Drexel University College of 
      Medicine, Philadelphia, Pennsylvania.
FAU - Aleem, Sarah Y
AU  - Aleem SY
AD  - Department of Medicine, Nazareth Hospital, Philadelphia, Pennsylvania.
FAU - Kutalek, Steven P
AU  - Kutalek SP
AD  - Division of Cardiology, Department of Medicine, Drexel University College of 
      Medicine, Philadelphia, Pennsylvania.
FAU - Vielemeyer, Ole
AU  - Vielemeyer O
AD  - Division of Infectious Diseases and HIV Medicine, Department of Medicine, Drexel 
      University College of Medicine, Philadelphia, Pennsylvania.
AD  - Division of Infectious Diseases, Joan and Sanford I. Weill Department of 
      Medicine, Weill Cornell Medical College, New York, New York.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20151008
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Age Distribution
MH  - Bacteremia/*mortality
MH  - Defibrillators, Implantable/*statistics & numerical data
MH  - Equipment Design
MH  - Equipment Failure/*statistics & numerical data
MH  - Equipment Failure Analysis
MH  - Female
MH  - *Hospital Mortality
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Pacemaker, Artificial/*statistics & numerical data
MH  - Philadelphia/epidemiology
MH  - Prosthesis-Related Infections/*mortality
MH  - Risk Assessment/methods
MH  - Sex Distribution
MH  - Survival Rate
OTO - NOTNLM
OT  - bacteremia
OT  - defibrillator
OT  - pace12748maker
OT  - retrospective study
EDAT- 2015/09/10 06:00
MHDA- 2017/01/11 06:00
CRDT- 2015/09/10 06:00
PHST- 2015/04/04 00:00 [received]
PHST- 2015/07/21 00:00 [revised]
PHST- 2015/08/20 00:00 [accepted]
PHST- 2015/09/10 06:00 [entrez]
PHST- 2015/09/10 06:00 [pubmed]
PHST- 2017/01/11 06:00 [medline]
AID - 10.1111/pace.12748 [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2015 Dec;38(12):1456-63. doi: 10.1111/pace.12748. 
      Epub 2015 Oct 8.