Predictors of mortality in patients with cardiovascular implantable electronic device infections

Ammar Habib, Katherine Y. Le, Larry M. Baddour, Paul Andrew Friedman, David L. Hayes, Christine M. Lohse, Walter R. Wilson, James M. Steckelberg, M. Rizwan Sohail

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Infection reduces survival in cardiovascular implantable electronic device (CIED) recipients. However, the clinical predictors of short- and long-term mortality in patients with CIED infection are not well understood. We retrospectively reviewed all patients with CIED infection who were admitted to Mayo Clinic from January 1991 to December 2008. Survival data were obtained from the medical records and the United Sates Social Security Index. The purported risk factors for short-term (30-day) and long-term (>30-day) mortality were analyzed using univariate and multivariate models. Overall, 415 cases of CIED infection were identified during the study period. The mean follow-up duration for the 243 patients who were alive at the last follow-up visit was 6.9 years. In a multivariate model, heart failure (odds ratio 9.31, 95% confidence interval 2.08 to 41.67), corticosteroid therapy (odds ratio 4.04, 95% confidence interval 1.40 to 11.60), and presentation with CIED-related infective endocarditis (odds ratio 5.60, 95% confidence interval 2.25 to 13.92) were associated with increased short-term mortality. The factors associated with long-term mortality in the multivariate model included patient age (hazard ratio 1.20, 95% confidence interval 1.06 to 1.36), heart failure (hazard ratio 2.01, 95% confidence interval 1.42 to 2.86), metastatic malignancy (hazard ratio 5.99, 95% confidence interval 1.67 to 21.53), corticosteroid therapy (hazard ratio 1.97, 95% confidence interval 1.22 to 3.18), renal failure (hazard ratio 1.94, 95% confidence interval 1.37 to 2.74), and CIED-related infective endocarditis (hazard ratio 1.68, 95% confidence interval 1.17 to 2.41). In conclusion, these data suggest that the development of CIED-related infective endocarditis and the presence of co-morbid conditions are associated with increased short- and long-term mortality in patients with CIED infection.

Original languageEnglish (US)
Pages (from-to)874-879
Number of pages6
JournalAmerican Journal of Cardiology
Volume111
Issue number6
DOIs
StatePublished - 2013

Fingerprint

Confidence Intervals
Equipment and Supplies
Mortality
Infection
Endocarditis
Odds Ratio
Adrenal Cortex Hormones
Heart Failure
Survival
Social Security
Medical Records
Renal Insufficiency
Therapeutics
Neoplasms

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Predictors of mortality in patients with cardiovascular implantable electronic device infections. / Habib, Ammar; Le, Katherine Y.; Baddour, Larry M.; Friedman, Paul Andrew; Hayes, David L.; Lohse, Christine M.; Wilson, Walter R.; Steckelberg, James M.; Sohail, M. Rizwan.

In: American Journal of Cardiology, Vol. 111, No. 6, 2013, p. 874-879.

Research output: Contribution to journalArticle

Habib, A, Le, KY, Baddour, LM, Friedman, PA, Hayes, DL, Lohse, CM, Wilson, WR, Steckelberg, JM & Sohail, MR 2013, 'Predictors of mortality in patients with cardiovascular implantable electronic device infections', American Journal of Cardiology, vol. 111, no. 6, pp. 874-879. https://doi.org/10.1016/j.amjcard.2012.11.052
Habib, Ammar ; Le, Katherine Y. ; Baddour, Larry M. ; Friedman, Paul Andrew ; Hayes, David L. ; Lohse, Christine M. ; Wilson, Walter R. ; Steckelberg, James M. ; Sohail, M. Rizwan. / Predictors of mortality in patients with cardiovascular implantable electronic device infections. In: American Journal of Cardiology. 2013 ; Vol. 111, No. 6. pp. 874-879.
@article{e2bb595386384f9083d02a435cfc4d4a,
title = "Predictors of mortality in patients with cardiovascular implantable electronic device infections",
abstract = "Infection reduces survival in cardiovascular implantable electronic device (CIED) recipients. However, the clinical predictors of short- and long-term mortality in patients with CIED infection are not well understood. We retrospectively reviewed all patients with CIED infection who were admitted to Mayo Clinic from January 1991 to December 2008. Survival data were obtained from the medical records and the United Sates Social Security Index. The purported risk factors for short-term (30-day) and long-term (>30-day) mortality were analyzed using univariate and multivariate models. Overall, 415 cases of CIED infection were identified during the study period. The mean follow-up duration for the 243 patients who were alive at the last follow-up visit was 6.9 years. In a multivariate model, heart failure (odds ratio 9.31, 95{\%} confidence interval 2.08 to 41.67), corticosteroid therapy (odds ratio 4.04, 95{\%} confidence interval 1.40 to 11.60), and presentation with CIED-related infective endocarditis (odds ratio 5.60, 95{\%} confidence interval 2.25 to 13.92) were associated with increased short-term mortality. The factors associated with long-term mortality in the multivariate model included patient age (hazard ratio 1.20, 95{\%} confidence interval 1.06 to 1.36), heart failure (hazard ratio 2.01, 95{\%} confidence interval 1.42 to 2.86), metastatic malignancy (hazard ratio 5.99, 95{\%} confidence interval 1.67 to 21.53), corticosteroid therapy (hazard ratio 1.97, 95{\%} confidence interval 1.22 to 3.18), renal failure (hazard ratio 1.94, 95{\%} confidence interval 1.37 to 2.74), and CIED-related infective endocarditis (hazard ratio 1.68, 95{\%} confidence interval 1.17 to 2.41). In conclusion, these data suggest that the development of CIED-related infective endocarditis and the presence of co-morbid conditions are associated with increased short- and long-term mortality in patients with CIED infection.",
author = "Ammar Habib and Le, {Katherine Y.} and Baddour, {Larry M.} and Friedman, {Paul Andrew} and Hayes, {David L.} and Lohse, {Christine M.} and Wilson, {Walter R.} and Steckelberg, {James M.} and Sohail, {M. Rizwan}",
year = "2013",
doi = "10.1016/j.amjcard.2012.11.052",
language = "English (US)",
volume = "111",
pages = "874--879",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Predictors of mortality in patients with cardiovascular implantable electronic device infections

AU - Habib, Ammar

AU - Le, Katherine Y.

AU - Baddour, Larry M.

AU - Friedman, Paul Andrew

AU - Hayes, David L.

AU - Lohse, Christine M.

AU - Wilson, Walter R.

AU - Steckelberg, James M.

AU - Sohail, M. Rizwan

PY - 2013

Y1 - 2013

N2 - Infection reduces survival in cardiovascular implantable electronic device (CIED) recipients. However, the clinical predictors of short- and long-term mortality in patients with CIED infection are not well understood. We retrospectively reviewed all patients with CIED infection who were admitted to Mayo Clinic from January 1991 to December 2008. Survival data were obtained from the medical records and the United Sates Social Security Index. The purported risk factors for short-term (30-day) and long-term (>30-day) mortality were analyzed using univariate and multivariate models. Overall, 415 cases of CIED infection were identified during the study period. The mean follow-up duration for the 243 patients who were alive at the last follow-up visit was 6.9 years. In a multivariate model, heart failure (odds ratio 9.31, 95% confidence interval 2.08 to 41.67), corticosteroid therapy (odds ratio 4.04, 95% confidence interval 1.40 to 11.60), and presentation with CIED-related infective endocarditis (odds ratio 5.60, 95% confidence interval 2.25 to 13.92) were associated with increased short-term mortality. The factors associated with long-term mortality in the multivariate model included patient age (hazard ratio 1.20, 95% confidence interval 1.06 to 1.36), heart failure (hazard ratio 2.01, 95% confidence interval 1.42 to 2.86), metastatic malignancy (hazard ratio 5.99, 95% confidence interval 1.67 to 21.53), corticosteroid therapy (hazard ratio 1.97, 95% confidence interval 1.22 to 3.18), renal failure (hazard ratio 1.94, 95% confidence interval 1.37 to 2.74), and CIED-related infective endocarditis (hazard ratio 1.68, 95% confidence interval 1.17 to 2.41). In conclusion, these data suggest that the development of CIED-related infective endocarditis and the presence of co-morbid conditions are associated with increased short- and long-term mortality in patients with CIED infection.

AB - Infection reduces survival in cardiovascular implantable electronic device (CIED) recipients. However, the clinical predictors of short- and long-term mortality in patients with CIED infection are not well understood. We retrospectively reviewed all patients with CIED infection who were admitted to Mayo Clinic from January 1991 to December 2008. Survival data were obtained from the medical records and the United Sates Social Security Index. The purported risk factors for short-term (30-day) and long-term (>30-day) mortality were analyzed using univariate and multivariate models. Overall, 415 cases of CIED infection were identified during the study period. The mean follow-up duration for the 243 patients who were alive at the last follow-up visit was 6.9 years. In a multivariate model, heart failure (odds ratio 9.31, 95% confidence interval 2.08 to 41.67), corticosteroid therapy (odds ratio 4.04, 95% confidence interval 1.40 to 11.60), and presentation with CIED-related infective endocarditis (odds ratio 5.60, 95% confidence interval 2.25 to 13.92) were associated with increased short-term mortality. The factors associated with long-term mortality in the multivariate model included patient age (hazard ratio 1.20, 95% confidence interval 1.06 to 1.36), heart failure (hazard ratio 2.01, 95% confidence interval 1.42 to 2.86), metastatic malignancy (hazard ratio 5.99, 95% confidence interval 1.67 to 21.53), corticosteroid therapy (hazard ratio 1.97, 95% confidence interval 1.22 to 3.18), renal failure (hazard ratio 1.94, 95% confidence interval 1.37 to 2.74), and CIED-related infective endocarditis (hazard ratio 1.68, 95% confidence interval 1.17 to 2.41). In conclusion, these data suggest that the development of CIED-related infective endocarditis and the presence of co-morbid conditions are associated with increased short- and long-term mortality in patients with CIED infection.

UR - http://www.scopus.com/inward/record.url?scp=84884212690&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84884212690&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2012.11.052

DO - 10.1016/j.amjcard.2012.11.052

M3 - Article

C2 - 23276467

AN - SCOPUS:84884212690

VL - 111

SP - 874

EP - 879

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 6

ER -