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Predictors of infection after “de novo” cardiac electronic device implantation

  • C. Balla
    Correspondence
    Corresponding author: Centro Cardiologico Universitario, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro, 8, 44124 Cona, Ferrara (FE), Italy.
    Affiliations
    Cardiovascular Institute, Department of Medical Sciences, University of Ferrara, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy
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  • A. Brieda
    Affiliations
    Cardiovascular Institute, Department of Medical Sciences, University of Ferrara, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy
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  • A. Righetto
    Affiliations
    Cardiovascular Institute, Department of Medical Sciences, University of Ferrara, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy
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  • F. Vitali
    Affiliations
    Cardiovascular Institute, Department of Medical Sciences, University of Ferrara, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy
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  • M. Malagù
    Affiliations
    Cardiovascular Institute, Department of Medical Sciences, University of Ferrara, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy

    Infectious Diseases, Department of Medical Sciences, University of Ferrara, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy
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  • R. Cultrera
    Affiliations
    Infectious Diseases, Department of Medical Sciences, University of Ferrara, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy
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  • M. Bertini
    Affiliations
    Cardiovascular Institute, Department of Medical Sciences, University of Ferrara, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy
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Published:February 29, 2020DOI:https://doi.org/10.1016/j.ejim.2020.02.030

      Highlights

      • Cardiac device infection is a major complication that increases morbidity and mortality after the procedure.
      • Several patient-related and device related factors have been identified as predictors of device infection.
      • a Shariff score > 4 has been identified as a predictor of higher risk of infection in patients after de novo device implantation and may help to implement strategies to prevent infections.

      Abstract

      Background

      Cardiac implantable electronic device (CIED) infection is a major complication that increases morbidity and mortality after the procedure. Several infection risk scores have been suggested to identify patients at higher pre-procedural risk of infection

      Objective

      this study sought to evaluate rates of infection, potential risk factors and the role of a modified “Shariff” score as predictor of infection in high-risk patients undergoing de novo CIED implantation.

      Methods and Results

      We retrospectively analysed 1391 patients underwent a de novo CIED procedure during the study period. At the median follow-up of 48 months, 20 patients of 1391 (1.4%) developed a CIED-related infective event. In our population, we studied a modified version of the “Shariff” score for only first-time implant patients. At multivariate regression analysis, three factors were independent predictors of infection: previous pocket hematoma [RR 27.2 (8.30–54.02), p = 10−10], a Shariff Score ≥ 4 [RR 3.20 (1.29–12.59), p= 0.029]. and reintervention for catheter malfunction or dislocation [RR 3.57 (1.2–37.4), p= 0.048].

      Conclusions

      a “Shariff” score > 4 is suggested as a predictor of higher risk of infection in patients after de novo device implantation. The use of an infection risk score may help to improve tailored pre-operatory strategies to prevent infection.

      Keywords

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