Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada.
Infect Control Hosp Epidemiol. 2023 Oct;44(10):1607-1613. doi: 10.1017/ice.2023.48. Epub 2023 May 15.
To establish the epidemiology of cardiac implantable electronic device (CIED) infections in Alberta, Canada, using validated administrative data.
Retrospective, population-based cohort study.
Alberta Health Services is a province-wide health system that services all of Alberta, Canada.
Adult patients who underwent first-time CIED implantation or generator replacement in Alberta, Canada, between January 1, 2011, and December 31, 2019.
CIED implant patients were identified from the Paceart database. Patients who developed an infection within 1 year of the index procedure were identified through validated administrative data (International Classification of Diseases, Tenth Revision in Canada). Demographic characteristics of patients were summarized. Logistic regression models were used to analyze device type, comorbidities, and demographics associated with infection rates and mortality.
Among 27,830 CIED implants, there were 205 infections (0.74%). Having 2 or more comorbidities was associated with higher infection risk. Generator replacement procedures (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.34-0.84; P = .008), age increase of every 10 years (OR, 0.73; 95% CI, 0.66-0.82; P ≤ .001), and index procedure after 2014 were associated with decreased risk. Comparing the infected to uninfected groups, the hospitalization rates were 2.63 compared to 0.69, and the mortality rates were 10.73% compared to 3.49%, respectively (P < .001).
There is a slightly lower overall rate of CIED infections Alberta, Canada compared to previously described epidemiology. Implants after 2014, and generator replacements showed a decreased burden of infection. Patients with younger age, and 2 or more comorbidities are at greatest risk of CIED infection. The burden of hospitalization and mortality is substantially higher in infected patients.
利用验证后的行政数据，确定加拿大艾伯塔省心脏植入式电子设备（CIED）感染的流行病学情况。
回顾性、基于人群的队列研究。
艾伯塔省卫生服务局是一个覆盖全省的卫生系统，为加拿大艾伯塔省的所有人提供服务。
2011 年 1 月 1 日至 2019 年 12 月 31 日期间，在加拿大艾伯塔省接受首次 CIED 植入或更换的成年患者。
从 Paceart 数据库中确定 CIED 植入患者。通过验证后的行政数据（加拿大第十版国际疾病分类）确定索引手术后 1 年内发生感染的患者。总结患者的人口统计学特征。使用逻辑回归模型分析与感染率和死亡率相关的设备类型、合并症和人口统计学特征。
在 27830 例 CIED 植入中，有 205 例（0.74%）发生感染。患有 2 种或更多种合并症与更高的感染风险相关。与感染风险相关的因素包括更换为发生器（比值比[OR]，0.55；95%置信区间[CI]，0.34-0.84；P=0.008）、年龄每增加 10 岁（OR，0.73；95%CI，0.66-0.82；P≤0.001）和 2014 年后进行的索引手术。与未感染组相比，感染组的住院率为 2.63 比 0.69，死亡率为 10.73%比 3.49%（P<0.001）。
与之前描述的流行病学情况相比，加拿大艾伯塔省的 CIED 感染总发生率略低。2014 年后植入的设备和更换的发生器显示出感染负担降低。年龄较小和患有 2 种或更多种合并症的患者感染 CIED 的风险最大。感染患者的住院和死亡率负担明显更高。
