Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, 21070, Diyarbakır, Turkey.
Department of Cardiology, Mardin Training and Research Hospital, Mardin, Turkey.
Aging Clin Exp Res. 2023 Nov;35(11):2445-2452. doi: 10.1007/s40520-023-02524-6. Epub 2023 Aug 21.
In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥ 75 years) than in younger (< 75 years) patients.
This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point.
The overall sample included 1923 patients (1419 < 75 years and 504 aged ≥ 75 years). There was no difference between the groups in terms of cumulative events defined as primary outcome (3.5% vs. 4.4%, p = 0.393). Infection related to device system was significantly higher in the ≥ 75 age group (1.8% vs. 3.4%, p = 0.034). There was no significant difference between the groups in terms of clinically significant hematoma and pneumothorax (0.7% vs. 0.4%, p = 0.451, 1.4% vs. 1.0%, p = 0.477, respectively). In multivariate model analysis, no association was found between age ≥ 75 years and infection related to the device system.
Infection rates were relatively higher in the patient group aged ≥ 75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.
本研究旨在探讨在土耳其两家心脏中心接受心脏植入式电子设备（CIED）程序（初次植入、系统升级、更换除颤器、囊袋翻修或导线更换）的患者中，年龄≥75 岁者与年龄<75 岁者相比，CIED 相关并发症的发生率是否更高。
本回顾性队列研究纳入了 2011 年 1 月至 2023 年 5 月期间在土耳其的两家心脏中心接受 CIED 程序的患者。主要复合终点包括临床显著血肿（CSH）、心包积液或填塞、气胸和与设备系统相关的感染。次要结局包括复合终点的每个组成部分。
总体样本包括 1923 名患者（<75 岁者 1419 名，≥75 岁者 504 名）。两组在定义为主要结局的累积事件方面无差异（3.5%比 4.4%，p=0.393）。≥75 岁年龄组与设备系统相关的感染明显更高（1.8%比 3.4%，p=0.034）。两组在临床显著血肿和气胸方面无显著差异（0.7%比 0.4%，p=0.451，1.4%比 1.0%，p=0.477）。在多变量模型分析中，年龄≥75 岁与设备系统相关感染之间无关联。
年龄≥75 岁的患者组感染率相对较高。在程序前后，应更仔细地评估该患者组感染的发生情况。
