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



Boriani, Giuseppe, Proietti, Marco ORCID: 0000-0003-1452-2478, Bertini, Matteo, Diemberger, Igor, Palmisano, Pietro, Baccarini, Stefano, Biscione, Francesco, Bottoni, Nicola, Ciccaglioni, Antonio, Dal Monte, Alessandro
et al (show 13 more authors) (2022) 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, 12 (1). 91-.

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Abstract

<h4>Background</h4>The incidence of infections associated with cardiac implantable electronic devices (CIEDs) and patient outcomes are not fully known.<h4>Aim</h4>To provide a contemporary assessment of the risk of CIEDs infection and associated clinical outcomes.<h4>Methods</h4>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.<h4>Results</h4>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), <i>p</i> = 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) <i>p</i> < 0.001.<h4>Conclusions</h4>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.

Item Type: Article
Uncontrolled Keywords: cardiac implantable electronic device, implantable defibrillator, pacemaker, infection, outcome
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 26 Oct 2022 10:39
Last Modified: 07 Feb 2024 01:33
DOI: 10.3390/jpm12010091
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3165777