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Outcomes of infected cardiovascular implantable devices in dialysis patients

Oluwaseun Opelami1, Ankit Sakhuja, Xiaobo Liu

  • 1Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA.

American Journal of Nephrology
|October 18, 2014
PubMed

Insights

Hospitalizations for cardiovascular implantable electronic device (CIED) infections are increasing in dialysis patients. These patients face higher mortality, longer hospital stays, and increased costs compared to non-dialysis patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Infectious Diseases

Background:

  • Patients undergoing dialysis have a higher risk of cardiovascular implantable electronic device (CIED) infections.
  • CIED infections lead to significant hospitalizations and adverse outcomes.

Purpose of the Study:

  • To compare outcomes and costs of CIED infection hospitalizations between dialysis and non-dialysis patients.
  • To analyze trends in CIED infection hospitalizations among dialysis patients.

Main Methods:

  • Retrospective analysis of Nationwide Inpatient Sample (NIS) discharge records (2005-2010).
  • Identification of CIED infections and dialysis status using ICD-9 codes.
  • Multivariable logistic and linear regressions to assess mortality, length of stay, and cost.

Main Results:

  • Dialysis patients constituted 7.6% of CIED infection hospitalizations, with increasing trends.
  • In-hospital mortality was significantly higher in dialysis patients (13.6% vs. 5.9%).
  • Dialysis patients experienced longer hospital stays (12 vs. 7 days), higher need for extended care (51.2% vs. 35.0%), and 50.3% increased hospitalization costs.

Conclusions:

  • CIED infection hospitalizations are rising among dialysis patients.
  • These hospitalizations are associated with increased in-hospital mortality, prolonged hospital stays, and elevated costs.
  • Further research is needed to understand the high-risk factors and improve outcomes for dialysis patients with CIED infections.
Abstract

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