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2022-10-14

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cc-by-nc-nd (c) Hernández-Meneses, Marta et al., 2022
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/195064

Forty-Year Trends in Cardiac Implantable Electronic Device Infective Endocarditis

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https://doi.org/10.1093/ofid/ofac547

Resum

Background: Studies investigating cardiac implantable electronic device infective endocarditis (CIED-IE) epidemiological changes and prognosis over long periods of time are lacking. Methods: Retrospective single cardiovascular surgery center cohort study of definite CIED-IE episodes between 1981-2020. A comparative analysis of two periods (1981-2000 vs 2001-2020) was conducted to analyze changes in epidemiology and outcome over time. Results: One-hundred and thirty-eight CIED-IE episodes were diagnosed: 25 (18%) first period and 113 (82%) second. CIED-IE was 4.5 times more frequent in the second period, especially in implantable cardiac defibrillators. Age (63 [53-70] vs 71 [63-76] years, P < .01), comorbidities (CCI 3.0 [2-4] vs 4.5 [3-6], P > .01), nosocomial infections (4% vs 15.9%, P = .02) and transfers from other centers (8% vs 41.6%, P < .01) were significantly more frequent in the second period, as were methicillin-resistant coagulase-negative staphylococcal (MR-CoNS) (0% vs 13.3%, P < .01) and Enterococcus spp. (0% vs 5.3%, P = .01) infections, pulmonary embolism (0% vs 10.6%, P < .01) and heart failure (12% vs 28.3%, p < .01). Second period surgery rates were lower (96% vs 87.6%, P = .09), and there were no differences in in-hospital (20% vs 11.5%, P = .11) and one-year mortalities (24% vs 15%, P = .33), or relapses (8% vs 5.3%, P = 0.65). Multivariate analysis showed Charlson index (hazard ratios [95% confidence intervals]; 1.5 [1.16-1.94]) and septic shock (23.09 [4.57-116.67]) were associated with a worse prognosis, whereas device removal (0.11 [.02-.57]), transfers (0.13 [.02-0.95]), and second-period diagnosis (0.13 [.02-.71]) were associated with better one-year outcomes. Conclusions: CIED-IE episodes increased more than four-fold during last 40 years. Despite CIED-IE involved an older population with more comorbidities, antibiotic-resistant MR-CoNS, and complex devices, one-year survival improved.

Matèries

Pronòstic mèdic, Epidemiologia, Endocarditis

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Prognosis, Epidemiology, Endocarditis

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Articles publicats en revistes (Genètica, Microbiologia i Estadística)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Medicina)

Citació

HERNÁNDEZ-MENESES, Marta, LLOPIS PÉREZ, Jaime, SANDOVAL, Elena, NINOT, Salvador, ALMELA, M. (manel), FALCES SALVADOR, Carles, PERICÀS, Juan m., VIDAL, Barbara, PERISSINOTTI, Andrés, MARCO REVERTÉ, Francesc, MESTRES, Carlos a., PARE I BARDERA, J. carles, GARCÍA DE LA MARÍA, Cristina, CUERVO REQUENA, Guillermo, QUINTANA, Eduard, TOLOSANA, José m. (josé maría), MORENO CAMACHO, Ma. asunción, MIRÓ MEDA, José m. (josé maría), Hospital Clinic Infective Endocarditis Team Investigators. Forty-Year Trends in Cardiac Implantable Electronic Device Infective Endocarditis. _Open Forum Infectious Diseases_. 2022. Vol. 9, núm. 11, pàgs. 1-11. [consulta: 21 de gener de 2026]. ISSN: 2328-8957. [Disponible a: https://hdl.handle.net/2445/195064]

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