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. 2014;40(3):280-7.
doi: 10.1159/000366453. Epub 2014 Oct 15.

Outcomes of infected cardiovascular implantable devices in dialysis patients

Oluwaseun Opelami  1 , Ankit Sakhuja, Xiaobo Liu, W H Wilson Tang, Jesse D Schold, Sankar D Navaneethan
Affiliations

Outcomes of infected cardiovascular implantable devices in dialysis patients

Oluwaseun Opelami et al. Am J Nephrol. 2014.

Abstract

Background/aims: Dialysis patients are at a higher risk for cardiovascular implantable electronic device (CIED) infection-related hospitalizations. We compared the outcomes and cost for dialysis and non-dialysis patients hospitalized with CIED infections.

Methods: We conducted a retrospective analysis of the Nationwide Inpatient Sample (NIS) discharge records from 2005 to 2010. Patients with CIED infections were identified using ICD-9 codes for device-related infections or device procedure along with bacteremia, endocarditis or systemic infection. Dialysis patients were identified using ICD-9 codes. Multivariable logistic and linear regressions were performed to examine in-hospital mortality, length of stay and cost.

Results: Of the 87,798 estimated hospitalizations with CIED infections, 6,665 (7.6%) were dialysis patients. CIED-infection-related hospitalization has increased over time among dialysis patients. In-hospital mortality was higher among dialysis patients (13.6% vs. 5.9%, p < 0.001). In the multivariable model, dialysis patients had higher odds of in-hospital mortality (odds ratio 1.98; 95% CI: 1.6, 2.4) compared to the non-dialysis group. Dialysis patients had a longer median length of stay (12 days vs. 7 days, p < 0.001) and majority required extended care facility upon discharge (51.2% vs. 35.0%, p < 0.001) compared to the non-dialysis group. Dialysis status was associated with 50.3% increased cost of hospitalization (p < 0.001).

Conclusion: CIED-infection related hospitalization is increasing among patients undergoing dialysis and is associated with higher in-hospital mortality, longer hospital stay and higher costs of hospitalization. Future studies should examine the reasons for such a high risk and find means to improve outcomes in dialysis population.

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Figures

Figure 1
Figure 1
Selection of study cohort
Figure 2
Figure 2
CIED-infection related hospitalizations over time among dialysis and non-dialysis patients
See this image and copyright information in PMC

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