心脏植入电子设备感染患者中的提取和死亡率
Sean D Pokorney1,2, Lindsay Zepel3, Melissa A Greiner3
1Duke University Medical Center, Durham, North Carolina.
JAMA cardiology
|October 18, 2023
概括
对于心血管植入式电子设备 (CIED) 感染,建议完全移除硬件,但未得到充分利用. 早期提取显著降低了CIED感染患者的死亡风险.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 医疗保健服务研究 医疗服务研究
背景情况:
- 完全移除硬件是心血管植入式电子设备 (CIED) 感染的I类建议.
- 然而,目前关于CIED提取的现实实践模式和结果尚不清楚.
研究的目的:
- 在医疗保险受益者中量化CIED感染和提取的发病率.
- 分析与CIED提取相关的结果,特别是死亡率,在全国临床实践队列中.
主要方法:
- 一项回顾性队列研究分析了从2006年到2019年的服务费医疗保险D部分受益者.
- 确定了CIED植入和感染>1年植入后的患者.
- 时间变化的多变量考克斯比例危险回归模型评估了提取和生存之间的关联.
主要成果:
- 11,304名患者 (1.1%) 患有CIED感染;18.6%的患者在30天内接受了提取.
- 感染发生在植入后平均3.7年;一年生存率为68.3%.
- 任何提取都与较低的死亡率有关 (AHR,0.82),提取在6天内显示出最大的益处 (AHR,0.69).
结论:
- 一小部分患有CIED感染的患者接受了推的提取.
- 提取,特别是提取较早,与显著降低的死亡率有关.
- 调查结果强调需要改善对CIED感染的指导方针导向护理的遵守.
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