Study Computes Cardiac Device Infection Mortality, Costs

(National Institutes of Health)

A review of Medicare records shows that surgical infections associated with pacemakers and defibrillators led to longer hospital stays, higher mortalities, and increased hospitalization costs compared to implantations without infections. Results of the study, funded by medical device developer TYRX Inc. in Monmouth Junction, New Jersey, were presented yesterday at a meeting of the American College of Cardiology.

The research team from the Mayo Clinic, The Johns Hopkins School of Medicine, and TYRX Inc. studied the records of 200,000 Medicare beneficiaries who received pacemaker and defibrillator implantations. TYRX, Inc. develops implantable devices that combine drugs and devices focusing on infection control.

Their findings show in-hospital mortality rate for pacemaker and defibrillator implantation admissions with an infection was 8 to 11 times the rate for non-infected admissions, depending on the device type. And the longer term mortality rate — defined as the rate of death among those who developed infections during the admission quarter and following year — was 27 to 36 percent, about twice the rate of those without infection, depending on the device type.

The study shows the average length of stay in hospital among patients with infections was three times the length of stay of those without infection. Moreover the length of stay was substantially longer than the average stay for Medicare beneficiary admissions for the five leading principal diagnostic classifications: heart disease, pneumonia, malignant neoplasm, cerebrovascular disease, and fractures at all sites.

The findings indicate that total average hospitalization costs for pacemaker and defibrillator patients with an infection ranged from 55 to 118 percent higher than for those without infection, depending on the type of device. Additional costs, on average, for treating the infection ran from $17,000 per pacemaker infections to $25,600 for some defibrillators. The analysis also shows that the cost of managing the most extreme situations exceeded $1 million.

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