Baldauf Benito, Vonthein Reinhard, Lau Ernest W, Giaccardi Marzia, Assadian Ojan, Chévalier Philippe, Haddad Christelle, Bode Kerstin, Klöss Andreas, Cemin Roberto, Bonnemeier Hendrik
Institute of Life Sciences, Hochschule Bremerhaven, An der Karlstadt 8, 27568, Bremerhaven, Germany.
Medical Faculty, Christian-Albrechts University, Christian-Albrechts-Platz 4, 24118, Kiel, Germany.
Sci Rep. 2024 Dec 16;14(1):30513. doi: 10.1038/s41598-024-82622-1.
The placement of cardiovascular implantable electronic devices (CIED) comes with a risk of adverse events (AE). AE comprise complications associated with the procedure and the device. CIED infection is a severe AE. Reported CIED infection rates are regionally differing and publications of contemporary large cohort data regarding CIED infections for Germany are lacking. This investigation provides rates of CIED infection related hospital admission and CIED infection related mortality in Germany. Data from Germany's largest healthcare insurance fund was screened for CIED procedures during the period: January to December 2015. These data included placement, revision with aim to up- or downgrade, generator substitution, early revision and partial or complete extraction using specific procedure codes for reimbursement. Among the total population of beneficiaries undergoing CIED procedures, International Classification of Diseases codes (ICD 10 GM), operational and procedural codes for partial or complete hardware removal were used to identify CIED infections and lead related endocarditis. To report the corresponding mortality rates, the hospital discharge status was documented. In 2015, from a population of more than 27 million beneficiaries, we identified the cohort of 60,296 patients (57.3% male) who underwent any invasive CIED procedure. Within three months from the index procedure, 1,595 patients developed a major CIED infection. 1,129 (1.87%) were related to the generator pocket and 466 (0.8%) were related to the transvenous proportions of the leads, mortality after those infections was 8.4% and 15.24%, respectively. In summary, our data reveals a higher prevalence of acute CIED infection than previously noted. The elevated number of additional procedures in cases of CIED infection implies a deficiency in infection awareness.
心血管植入式电子设备（CIED）的植入存在不良事件（AE）风险。AE包括与手术及设备相关的并发症。CIED感染是一种严重的AE。报告的CIED感染率因地区而异，且缺乏关于德国CIED感染的当代大型队列数据的出版物。本调查提供了德国CIED感染相关住院率和CIED感染相关死亡率。对德国最大的医疗保险基金在2015年1月至12月期间的CIED手术数据进行了筛查。这些数据包括植入、旨在升级或降级的修订、发生器置换、早期修订以及使用特定报销程序代码进行的部分或完全拔除。在接受CIED手术的受益人群中，使用国际疾病分类代码（ICD - 10 GM）、部分或完全硬件移除的操作和程序代码来识别CIED感染和导线相关的心内膜炎。为报告相应的死亡率，记录了医院出院状态。2015年，在超过2700万受益人群中，我们确定了60296例接受任何侵入性CIED手术的患者队列（男性占57.3%）。在索引手术的三个月内，1595例患者发生了严重的CIED感染。其中1129例（1.87%）与发生器囊袋有关，466例（0.8%）与导线的经静脉部分有关，这些感染后的死亡率分别为8.4%和15.24%。总之，我们的数据显示急性CIED感染的患病率高于先前记录。CIED感染病例中额外手术数量的增加意味着感染意识的不足。
