Abstract 17922: Long-term Mortality After Cardiovascular Implantable Electronic Device Infection
Background: There is limited data available on the incidence and predictors of long-term mortality of cardiovascular-implantable electronic device (CIED) infections
Methods: We evaluated the incidence and predictors of long-term mortality after CIED infections in a large academic center. Baseline characteristics, clinical presentation and treatment variables were collected. Mortality data was collected from medical records and social security death index.
Results: Between 2005 and 2011, 118 patients with CIED infections were referred to our institute and are included in the study. Mean age was 69±15years with 78% males. Pacemaker, implantable defibrillator and cardiac resynchronization therapy-defibrillators were infected in 42%, 23% and 36% of the patients respectively. Patients were admitted with CIED infection after a median duration of 5 months from the last device procedure. Infective endocarditis (IE) defined with modified Duke criteria (positive blood cultures and vegetation on imaging) was seen in 21 (18%) patients. Staphylococcus aureus was isolated in 42 (36%) patients. In addition to intravenous antibiotics, complete device extraction was performed in 104 (88%) patients. After a mean follow-up of 24 months (IQ range 10-34 months, 36 (31%) patients died. In cox-multivariate regression analysis, including the age, gender, body mass index, coronary artery disease, left ventricular ejection fraction, creatinine, type of device, organism isolated and device extraction, the only independent predictors of death were age (HR 1.06; 6% increase in mortality/year; p<0.001) and infective endocarditis (HR 3.07; p=0.019). Median time to death in patients with IE was much shorter than those without IE (2.9 vs 12.9 months; p=0.04)
Conclusion: Infective endocarditis is associated with 3 times the hazard of death in patients with CIED infection independent of the baseline clinical characteristics and treatment offered.
- © 2012 by American Heart Association, Inc.