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16-Year Trends in the Infection Burden for Pacemakers and Implantable Cardioverter-Defibrillators in the United States
JACC - Journal of the American College of Cardiology, 09/08/2011
Greenspon AJ et al. – The infection burden associated with cardiac implantable electrophysiological device (CIED) implantation is increasing over time and is associated with prolonged hospital stays and high financial costs.
Methods- The Nationwide Inpatient Sample (NIS) discharge records were queried between 1993 and 2008 using the 9th Revision of the International Classification of Diseases (ICD–9–CM).
- CIED infection was defined as either:
- ICD–9 code for device–related infection (996.61) and any CIED procedure or removal code;
- Or CIED procedure code along with systemic infection.
- Patient health profile was evaluated by coding for renal failure, heart failure, respiratory failure, and diabetes mellitus.
- The infection burden and patient health profile were calculated for each year, and linear regression was used to test for changes over time.
- During the study period (1993 to 2008), the incidence of CIED infection was 1.61%.
- The annual rate of infections remained constant until 2004, when a marked increase was observed, which coincided with an increase in the incidence of major comorbidities.
- This was associated with a marked increase in mortality and in–hospital financial charges.