Prognostic role of aetiological agent vs. clinical pattern in candidates to lead extraction for cardiac implantable electronic device infections
2024

Impact of Infection Type on Heart Device Outcomes

Sample size: 157 publication Evidence: high

Author Information

Author(s): Massaro Giulia, Pascale Renato, Biffi Mauro, Martignani Cristian, Ziacchi Matteo, Simeone Andrea, Pittorru Raimondo, De Lazzari Manuel, Migliore Federico, Diemberger Igor

Primary Institution: University of Bologna

Hypothesis

The study aims to explore the contribution of aetiological agents and clinical patterns on overall mortality in patients undergoing transvenous lead extraction for cardiac implantable electronic device infections.

Conclusion

The study found that both the type of infection and the presence of Staphylococcus aureus significantly affect mortality outcomes in patients with cardiac device infections.

Supporting Evidence

  • 157 patients were enrolled in the study, with a mean age of 71.3 years.
  • S. aureus was isolated in 32.5% of patients, linked to worse outcomes.
  • The BOP2D score developed in the study had a predictive value with an AUC of 0.807.
  • Patients with 'cold closed pocket' infections had significantly worse outcomes.
  • 28 patients (17.8%) died within one year, primarily from heart failure or multi-organ failure.

Takeaway

This study shows that infections in heart devices can be really serious, especially if caused by certain germs like Staphylococcus aureus, and that how the infection looks can also change how likely someone is to get better.

Methodology

A prospective study was conducted from 2011 to 2021, including patients undergoing transvenous lead extraction with microbiologically confirmed infections.

Potential Biases

Potential bias due to differences in management and aetiological distribution between the two centers involved in the study.

Limitations

The study's cohorts were from different centers, which may have influenced the results, and the lack of advanced molecular diagnostic methods could limit microbiological diagnosis.

Participant Demographics

Mean age of participants was 71.3 years, with 81.5% being male.

Statistical Information

P-Value

p<0.001

Confidence Interval

95%CI 0.703–0.910

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1038/s41598-024-73147-8

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