Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Cardiology - Kahramanmaraş, Turkey.
Necip Fazıl City Hospital, Department of Infectious Diseases - Kahramanmaraş, Turkey.
Rev Assoc Med Bras (1992). 2024 May 3;70(4):e20230998. doi: 10.1590/1806-9282.20230998. eCollection 2024.
The use of cardiac implantable electronic devices has increased in recent years. It has also brought some issues. Among these, the complications of cardiac implantable electronic devices infection and pocket hematoma are difficult to manage. It can be fatal with the contribution of patient-related risk factors. In this study, we aimed to find mortality rates in patients who developed cardiac implantable electronic devices infection and pocket hematoma over 5 years. We also investigated the risk factors affecting mortality in patients with cardiac implantable electronic devices.
A total of 288 cardiac implantable electronic devices patients were evaluated. Demographic details, history, and clinical data of all patients were recorded. Cardiac implantable electronic devices infection was defined according to the modified Duke criteria. The national registry was used to ascertain the mortality status of the patients. The patients were divided into two groups (exitus and survival groups). In addition, the pocket hematoma was defined as significant bleeding at the pocket site after cardiac implantable electronic devices placement.
The cardiac implantable electronic devices infection was similar in both groups (p=0.919), and the pocket hematoma was higher in the exitus group (p=0.019). The exitus group had higher usage of P2Y12 inhibitors (p≤0.001) and novel oral anticoagulants (p=0.031). The Cox regression analysis, including mortality-related factors, revealed that renal failure is the most significant risk factor for mortality. Renal failure was linked to a 2.78-fold higher risk of death.
No correlation was observed between cardiac implantable electronic devices infection and mortality, whereas pocket hematoma was associated with mortality. Furthermore, renal failure was the cause of the highest mortality rate in patients with cardiac implantable electronic devices.
近年来，心脏植入式电子设备的使用有所增加。这也带来了一些问题。其中，心脏植入式电子设备感染和囊袋血肿的并发症难以处理。由于患者相关的危险因素的影响，这可能是致命的。在本研究中，我们旨在研究 5 年内发生心脏植入式电子设备感染和囊袋血肿的患者的死亡率。我们还研究了影响心脏植入式电子设备患者死亡率的危险因素。
共评估了 288 例心脏植入式电子设备患者。记录所有患者的人口统计学细节、病史和临床数据。根据改良的杜克标准定义心脏植入式电子设备感染。使用国家登记处确定患者的死亡状态。患者被分为两组（死亡组和存活组）。此外，囊袋血肿定义为心脏植入式电子设备放置后囊袋部位的明显出血。
两组患者的心脏植入式电子设备感染情况相似（p=0.919），死亡组的囊袋血肿发生率更高（p=0.019）。死亡组 P2Y12 抑制剂（p≤0.001）和新型口服抗凝剂（p=0.031）的使用率更高。包括与死亡率相关的因素的 Cox 回归分析显示，肾衰竭是导致死亡的最重要危险因素。肾衰竭与死亡风险增加 2.78 倍相关。
心脏植入式电子设备感染与死亡率之间没有相关性，而囊袋血肿与死亡率相关。此外，肾衰竭是导致心脏植入式电子设备患者死亡率最高的原因。
