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植入式心脏电子设备感染;拔除及抗生素治疗后的长期结局

Cardiac Implantable Electronic Device Infections; Long-Term Outcome after Extraction and Antibiotic Treatment.

作者信息

Hörnsten Jonas, Axelsson Louise, Westling Katarina

机构信息

Department of Cardiology, Karolinska University Hospital, 17176 Stockholm, Sweden.

Department of Medicine, Division of Infectious Diseases and Dermatology, Karolinska Institutet, 17177 Solna, Sweden.

出版信息

Infect Dis Rep. 2021 Jul 6;13(3):627-635. doi: 10.3390/idr13030059.

Abstract

BACKGROUND

The aim of the study was to examine the treatment outcome for patients with cardiovascular implantable electronic device (CIED) infections after extraction.

METHODS

Patients who underwent CIED extractions due to an infection at Karolinska University Hospital 2006-2015 were analyzed.

RESULTS

In total, 165 patients were reviewed, 104 (63%) with pocket infection and 61 (37%) with systemic infection. Of the patients with systemic infection, 34 and 25 patients fulfilled the criteria for definite and possible endocarditis, respectively. Complications after extraction occurred only in one patient. Reimplantation was made after a mean of 9.5 days and performed in 81% of those with pocket infection and 44.3% in systemic infection. Infection with the new device occurred in 4.6%. The mean length of hospital stay for patients with pocket infection was 5.7 days, compared to 38.6 days in systemic infection. One-year mortality was 7.7% and 22.2% in pocket infection and systemic infection, respectively. Patients with infection had a higher mortality.

CONCLUSIONS

In this study, the majority of the patients had a pocket CIED infection, with a short hospital stay. Patients with a systemic infection, and etiology, had a prolonged hospital stay and a higher mortality.

摘要

背景

本研究旨在探讨心血管植入式电子设备(CIED)感染患者拔除后的治疗结果。

方法

对2006年至2015年在卡罗林斯卡大学医院因感染接受CIED拔除的患者进行分析。

结果

共纳入165例患者,其中104例(63%)为囊袋感染,61例(37%)为全身感染。在全身感染患者中,分别有34例和25例符合确诊性和可能的心内膜炎标准。拔除后仅1例患者出现并发症。平均9.5天后进行再植入,囊袋感染患者中81%进行了再植入,全身感染患者中44.3%进行了再植入。新设备感染发生率为4.6%。囊袋感染患者的平均住院时间为5.7天,而全身感染患者为38.6天。囊袋感染和全身感染患者的1年死亡率分别为7.7%和22.2%。感染患者的死亡率更高。

结论

在本研究中,大多数患者为CIED囊袋感染,住院时间短。全身感染且病因明确的患者住院时间延长,死亡率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecf/8293088/d78a01617e63/idr-13-00059-g001.jpg

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