Incidence and Predictors of Infections and All-Cause Death in Patients with Cardiac Implantable Electronic Devices: The Italian Nationwide RI-AIAC Registry

Journal of Personalized Medicine

on behalf of RI-AIAC Registry Investigators¹  Daniele Porcelli²  Renato Pietro Ricci³  Michele Malagù⁴  Matteo Bertini⁴  Giuseppe Boriani⁵  Jacopo Francesco Imberti⁵  Stefano Baccarini⁶  Franco Alberto Ferrari⁷  Alessandro Dal Monte⁸  Francesco Biscione⁹  Pietro Palmisano^1,10  Roberto De Ponti^1,11  Giuseppe Stabile^1,12  Luca Santini^1,13  Antonio Ciccaglioni^1,14  Igor Diemberger^1,15  Stefano Sangiorgio^1,16  Saverio Iacopino^1,17  Marcello Piacenti^1,18  Marco Proietti^1,19  Davide Caruso^2,20  Massimo Zoni-Berisso^2,20  Nicola Bottoni^2,21 

[1] ;Arrhythmology Unit, Cardiology Department, S. Giovanni Calibita Fatebenefratelli Hospital, 00186 Rome, Italy;CardioArrhythmology Center, 00152 Rome, Italy;Cardiological Center, University of Ferrara, 44124 Ferrara, Italy;Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, Italy;Cardiology Unit, Emergency Department, Fidenza Hospital, 43036 Fidenza, Italy;Cardiology Unit, Rho Hospital, 20017 Rho, Italy;Cardiology Unit, Santa Maria delle Croci Hospital, 48121 Ravenna, Italy;Cardiology Unit, Santo Spirito Hospital, 00193 Rome, Italy;Cardiology Unit, ‘Card. Giovanni Panico’ Hospital, 73039 Tricase, Italy;Cardiovascular Department, Circolo Hospital, University of Insubria, 21100 Varese, Italy;Department of Cardiology, Clinica Montevergine, 83013 Mercogliano, Italy;Department of Cardiology, Ospedale GB Grassi, 00122 Ostia, Italy;Department of Cardiovascular Sciences, Sapienza-University of Rome, 00161 Rome, Italy;Department of Experimental, Diagnostic and Specialty Medicine, Institute of Cardiology, University of Bologna, Policlinico S. Orsola-Malpighi, 40138 Bologna, Italy;Electrophysiology Unit, Fatebenefratelli Hospital, 20121 Milan, Italy;Electrophysiology Unit, Maria Cecilia Hospital, 48033 Cotignola, Italy;Fondazione Toscana ‘Gabriele Monasterio’, 56124 Pisa, Italy;Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy;Padre Antero Micone Hospital, ASL 3 “Genovese”, 16153 Genova, Italy;Santa Maria Nuova Hospital, 42123 Reggio Emilia, Italy;

关键词: cardiac implantable electronic device;    implantable defibrillator;    pacemaker;    infection;    outcome;   

DOI  :  10.3390/jpm12010091

来源: DOAJ

【 摘 要 】

Background: The incidence of infections associated with cardiac implantable electronic devices (CIEDs) and patient outcomes are not fully known. Aim: To provide a contemporary assessment of the risk of CIEDs infection and associated clinical outcomes. Methods: In Italy, 18 centres enrolled all consecutive patients undergoing a CIED procedure and entered a 12-months follow-up. CIED infections, as well as a composite clinical event of infection or all-cause death were recorded. Results: A total of 2675 patients (64.3% male, age 78 (70–84)) were enrolled. During follow up 28 (1.1%) CIED infections and 132 (5%) deaths, with 152 (5.7%) composite clinical events were observed. At a multivariate analysis, the type of procedure (revision/upgrading/reimplantation) (OR: 4.08, 95% CI: 1.38–12.08) and diabetes (OR: 2.22, 95% CI: 1.02–4.84) were found as main clinical factors associated to CIED infection. Both the PADIT score and the RI-AIAC Infection score were significantly associated with CIED infections, with the RI-AIAC infection score showing the strongest association (OR: 2.38, 95% CI: 1.60–3.55 for each point), with a c-index = 0.64 (0.52–0.75), p = 0.015. Regarding the occurrence of composite clinical events, the Kolek score, the Shariff score and the RI-AIAC Event score all predicted the outcome, with an AUC for the RI-AIAC Event score equal to 0.67 (0.63−0.71) p < 0.001. Conclusions: In this Italian nationwide cohort of patients, while the incidence of CIED infections was substantially low, the rate of the composite clinical outcome of infection or all-cause death was quite high and associated with several clinical factors depicting a more impaired clinical status.

【 授权许可】

Unknown