John de Heide, Marisa van der Graaf, Marijn J Holl, Mark G Hoogendijk, Rohit E Bhagwandien, Sip A Wijchers, Dominic A M J Theuns, Tamas Szili-Torok, Felix Zijlstra, Mattie J Lenzen, Sing-Chien Yap
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Patients who received an antibacterial envelope were excluded from this study. The primary endpoint was hospitalization for a CIED infection in the first year after the procedure.</p><p><strong>Results: </strong>A total of 2333 CIED procedures were performed in the study period (mean age 61.6 ± 16.3 years, male sex 64.5%, previous CIED infection 1.7%, immunocompromised 5.4%). The median PADIT score was 4 (interquartile range, 2-6). CIED infection occurred in 10 patients (0.43%). The PADIT score had good discrimination in predicting major CIED infection (C-statistic 0.70; 95% confidence interval [CI] 0.54 to 0.86, P = 0.03). Using an optimal PADIT score cut-off value of 7, the risk of CIED infection was higher in the patients with a PADIT score of ≥ 7 in comparison to those with a lower PADIT score (1.23% vs. 0.26%, P = 0.02; odds ratio 4.8, 95% CI 1.4 to 16.6, P = 0.01).</p><p><strong>Conclusions: </strong>The PADIT score is a clinically useful score for identifying patients at high risk of developing CIED infection. The use of an antibacterial envelope in these high-risk patients may be cost-effective.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1419-1426"},"PeriodicalIF":2.1000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379746/pdf/","citationCount":"0","resultStr":"{\"title\":\"Device infection in patients undergoing pacemaker or defibrillator surgery: risk stratification using the PADIT score.\",\"authors\":\"John de Heide, Marisa van der Graaf, Marijn J Holl, Mark G Hoogendijk, Rohit E Bhagwandien, Sip A Wijchers, Dominic A M J Theuns, Tamas Szili-Torok, Felix Zijlstra, Mattie J Lenzen, Sing-Chien Yap\",\"doi\":\"10.1007/s10840-024-01759-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The use of an antibacterial envelope is cost-effective for patients at high risk of developing cardiac implantable electronic device (CIED) infection. The identification of these high-risk patients may be facilitated using a clinical risk score. The aim of the current study is to evaluate the PADIT score for identifying high-risk patients in patients undergoing a CIED procedure in a tertiary academic center.</p><p><strong>Methods: </strong>This was a retrospective single-center study of consecutive patients undergoing a CIED procedure between January 2016 and November 2021. Patients who received an antibacterial envelope were excluded from this study. The primary endpoint was hospitalization for a CIED infection in the first year after the procedure.</p><p><strong>Results: </strong>A total of 2333 CIED procedures were performed in the study period (mean age 61.6 ± 16.3 years, male sex 64.5%, previous CIED infection 1.7%, immunocompromised 5.4%). The median PADIT score was 4 (interquartile range, 2-6). CIED infection occurred in 10 patients (0.43%). The PADIT score had good discrimination in predicting major CIED infection (C-statistic 0.70; 95% confidence interval [CI] 0.54 to 0.86, P = 0.03). Using an optimal PADIT score cut-off value of 7, the risk of CIED infection was higher in the patients with a PADIT score of ≥ 7 in comparison to those with a lower PADIT score (1.23% vs. 0.26%, P = 0.02; odds ratio 4.8, 95% CI 1.4 to 16.6, P = 0.01).</p><p><strong>Conclusions: </strong>The PADIT score is a clinically useful score for identifying patients at high risk of developing CIED infection. 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引用次数: 0
摘要
背景:对心脏植入式电子装置(CIED)感染高风险患者使用抗菌包膜具有成本效益。临床风险评分可帮助识别这些高风险患者。本研究旨在评估 PADIT 评分在三级学术中心接受 CIED 手术患者中识别高风险患者的能力:这是一项回顾性单中心研究,研究对象为2016年1月至2021年11月期间接受CIED手术的连续患者。本研究不包括接受抗菌包膜治疗的患者。主要终点是术后第一年内因CIED感染而住院:研究期间共进行了2333例CIED手术(平均年龄61.6±16.3岁,男性占64.5%,既往CIED感染1.7%,免疫力低下5.4%)。PADIT评分中位数为4分(四分位间范围为2-6分)。10名患者(0.43%)感染了CIED。PADIT评分在预测重大CIED感染方面具有良好的区分度(C统计量为0.70;95%置信区间[CI] 0.54至0.86,P = 0.03)。采用最佳的PADIT评分临界值7,与PADIT评分较低的患者相比,PADIT评分≥7的患者发生CIED感染的风险更高(1.23% vs. 0.26%,P = 0.02;几率比4.8,95% CI 1.4 to 16.6,P = 0.01):PADIT评分是一种临床实用的评分方法,可用于识别CIED感染高风险患者。对这些高危患者使用抗菌包膜可能具有成本效益。
Device infection in patients undergoing pacemaker or defibrillator surgery: risk stratification using the PADIT score.
Background: The use of an antibacterial envelope is cost-effective for patients at high risk of developing cardiac implantable electronic device (CIED) infection. The identification of these high-risk patients may be facilitated using a clinical risk score. The aim of the current study is to evaluate the PADIT score for identifying high-risk patients in patients undergoing a CIED procedure in a tertiary academic center.
Methods: This was a retrospective single-center study of consecutive patients undergoing a CIED procedure between January 2016 and November 2021. Patients who received an antibacterial envelope were excluded from this study. The primary endpoint was hospitalization for a CIED infection in the first year after the procedure.
Results: A total of 2333 CIED procedures were performed in the study period (mean age 61.6 ± 16.3 years, male sex 64.5%, previous CIED infection 1.7%, immunocompromised 5.4%). The median PADIT score was 4 (interquartile range, 2-6). CIED infection occurred in 10 patients (0.43%). The PADIT score had good discrimination in predicting major CIED infection (C-statistic 0.70; 95% confidence interval [CI] 0.54 to 0.86, P = 0.03). Using an optimal PADIT score cut-off value of 7, the risk of CIED infection was higher in the patients with a PADIT score of ≥ 7 in comparison to those with a lower PADIT score (1.23% vs. 0.26%, P = 0.02; odds ratio 4.8, 95% CI 1.4 to 16.6, P = 0.01).
Conclusions: The PADIT score is a clinically useful score for identifying patients at high risk of developing CIED infection. The use of an antibacterial envelope in these high-risk patients may be cost-effective.
期刊介绍:
The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.