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Risk factors and time delay associated with cardiac device infections: Leiden device registry
J C Lekkerkerker1, C van Nieuwkoop, S A Trines
1Department of Cardiology, Leiden University Medical Center, Leiden 2300 RC, The Netherlands.
Heart (British Cardiac Society)
|November 28, 2008
Summary
Cardiac device infections (CDI) affect 2.2% of procedures, with many occurring over two years later. Key risk factors for CDI include renal dysfunction, device revisions, and oral anticoagulation use.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Device Technology
Background:
- Cardiac device infections (CDI) are a significant complication following implantation or revision procedures.
- Understanding the temporal patterns and risk factors for CDI is crucial for patient management and prevention strategies.
Purpose of the Study:
- To evaluate the time course, risk factors, culture results, and frequency of cardiac device infections (CDI).
Main Methods:
- A nested case-control study involving 75 patients with CDI and 75 matched controls.
- Data collected on device procedures performed between 2000 and 2007.
- Analysis included time to infection, culture results, and identification of independent risk factors.
Main Results:
- CDI occurred in 2.2% of 3410 device procedures.
- Infections presented with a wide time delay, with 24% occurring over 24 months post-procedure.
- Independent risk factors for CDI included device revision (OR 3.67), renal dysfunction (OR 4.64), and oral anticoagulation (OR 2.83).
Conclusions:
- Cardiac device infections occur in 2.2% of procedures, with a substantial proportion presenting late.
- Renal dysfunction, device revisions, and oral anticoagulation are significant risk factors for CDI.
- Timely identification and management of these risk factors are essential for reducing CDI incidence.
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