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Cardiac Device Infections Linked to Higher Costs, Mortality

Surgeon holds Medtronic pacemaker (Steve Winton/Flickr)A team of academic and industry researchers have found an association between infections from cardiovascular implantable electronic devices (CIEDs) and increases in mortality and hospital care costs. The findings from this study appear online in the journal Archives of Internal Medicine (paid subscription required).

The researchers, led by Muhammad Sohail, from the Mayo Clinic College of Medicine in Rochester, Minnesota, analyzed the records of more than 200,000 Medicare fee-for-service patients who were admitted for CIED generator implantation, replacement, or revision during 2007. The researchers used the Centers for Medicare and Medicaid Services’ payment-rate calculation methods, and noted admitting hospitals’ locations, teaching status, and indigent care loads to standardize charges.

The authors — including a researcher from TYRX Inc. in  Monmouth Junction, New Jersey, a developer of antibacterial envelopes for CIEDs — found a total of 5,817 admissions with infection. Depending on the CIED type, infection was associated with significant increases in adjusted admission mortality: 4.6 percent to 11.3 percent. Infection was also associated with higher long-term mortality: 26.5 percent to 35.1 percent, depending on type of device. About half of the incremental long-term mortality occurred after patients were discharged.

The team found the length and cost of hospital stays were higher when CIEDs become infected. Standardized length of hospital stays resulting from infections ranged from 15.5 to 24.3 days. With infections, the standardized adjusted incremental admission costs were $14,360 to $16,498, and total admission costs were $28,676 to $53,349, depending on CIED type.

Intensive care and pharmacy services accounted for more than half of the incremental admission costs from infections. When researchers adjusted long-term mortality rate and cost ratios with infection by CIED type, pacemakers were associated with significantly greater increases in both measures, compared with implantable cardioverter-defibrillators or cardiac resynchronization therapy/defibrillator devices.

Read more: Trials Show Potential Benefits of Remote ICD Monitoring

Photo: Steve Winton/Flickr

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