Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health.
Department of Nursing Care, Sendai Kousei Hospital.
Circ J. 2023 Jun 23;87(7):1000-1006. doi: 10.1253/circj.CJ-23-0103. Epub 2023 May 16.
Because the penetration of transvenous lead extraction (TLE) for cardiac implantable electronic device (CIED) infection has not been investigated in Japan, we conducted a population-based, retrospective, descriptive study to evaluate regional disparities in the use of TLE for CIED infection and the potential undertreatment of CIED infection using a nationwide insurance claims database.
Patients who underwent CIED implantation or generator exchange and TLE between April 2018 and March 2020 were identified. Moreover, the penetration ratio of TLE for CIED infection in each prefecture was estimated. CIED implantation and TLE were most prevalent in the age categories of 80-89 years (40.3%) and 80-89 years (36.9%), respectively. There was no correlation between the number of CIED implantations and that of TLE (rho=-0.087, 95% confidence interval -0.374 to 0.211, P=0.56). The median penetration ratio was 0.00 (interquartile range 0.00-1.29). Of the 47 prefectures, 6, comprising Okinawa, Miyagi, Okayama, Fukuoka, Tokyo, and Osaka, showed a penetration ratio ≥2.00.
Our study data indicated great regional disparities in the penetration of TLE and potential undertreatment of CIED infection in Japan. Additional measures are needed to address these issues.
由于日本尚未对经静脉心脏植入式电子设备（CIED）感染的经静脉导线拔除术（TLE）的普及率进行调查，因此我们开展了一项基于人群的回顾性描述性研究，使用全国性的保险理赔数据库来评估日本各地 TLE 治疗 CIED 感染的使用率差异以及 CIED 感染治疗不足的潜在情况。
我们确定了在 2018 年 4 月至 2020 年 3 月期间接受 CIED 植入或更换以及 TLE 的患者。此外，我们还估计了每个县 TLE 治疗 CIED 感染的普及率。80-89 岁年龄组的 CIED 植入术（40.3%）和 80-89 岁年龄组的 TLE（36.9%）最为常见。CIED 植入术和 TLE 的数量之间没有相关性（rho=-0.087，95%置信区间-0.374 至 0.211，P=0.56）。中位数普及率为 0.00（四分位间距 0.00-1.29）。在 47 个县中，6 个县（冲绳县、宫城县、冈山县、福冈县、东京都和大阪府）的普及率≥2.00。
我们的研究数据表明，日本 TLE 的普及率和 CIED 感染治疗不足的情况存在显著的地区差异。需要采取额外的措施来解决这些问题。
