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Risk Factors for Mortality in Cardiac Implantable Electronic Device (CIED) Infections: A Systematic Review and

Jinghao Nicholas Ngiam1, Tze Sian Liong2, Meng Ying Sim2

  • 1Division of Infectious Diseases, Department of Medicine, National University Health System, Singapore 119228, Singapore.

Journal of Clinical Medicine
|June 10, 2022
PubMed

Insights

Cardiac implantable electronic device (CIED) infections increase mortality risk. Staphylococcus aureus, heart failure, and embolic phenomena are key risk factors, while surgical removal improves outcomes.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Technology

Background:

  • Cardiac implantable electronic device (CIED) infections pose significant risks, including mortality.
  • Surgical device removal is often necessary, incurring substantial costs and morbidity.
  • Identifying mortality risk factors in CIED infections is crucial for patient management.

Purpose of the Study:

  • To systematically review literature and identify risk factors for mortality in patients with CIED infections.
  • To conduct a meta-analysis to quantify the association between various factors and mortality.
  • To evaluate the impact of treatment strategies on mortality outcomes.

Main Methods:

  • Systematic literature search of PubMed and Scopus up to June 2021.
  • Inclusion of twelve studies (10 retrospective, 2 prospective).
  • Meta-analysis using the restricted maximum likelihood method to determine mortality risk factors.

Main Results:

  • Overall mortality following CIED infection was 13.7%.
  • Staphylococcus aureus infection, heart failure, and embolic phenomena were associated with increased mortality.
  • Surgical CIED removal demonstrated lower mortality rates compared to antibiotic treatment alone.

Conclusions:

  • Staphylococcus aureus, heart failure, and embolic phenomena are significant risk factors for mortality in CIED infections.
  • Surgical intervention for CIED infections is associated with improved survival rates.
  • Early identification and management of these risk factors are essential for reducing mortality.
Abstract

Keywords:
cardiac implantable electronic deviceinfectionmortalityoutcomes

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