The relationship between pocket hematoma and risk of wound infection among patients with a cardiovascular implantable electronic device: An integrative review

Heart Lung. 2020 Jan-Feb;49(1):92-98. doi: 10.1016/j.hrtlng.2019.09.009. Epub 2019 Oct 10.


Background: Pocket hematoma is a common adverse event following the insertion of cardiovascular implantable electronic devices (CIEDs), but the risk of wound infections associated with a pocket hematoma is unclear.

Objectives: This integrative review aims to examine the relationship between pocket hematoma and risk of wound infection in a CIED population.

Methods: A comprehensive literature search for articles assessing the relationship between pocket hematoma and infection in four electronic databases was conducted in October 2018.

Results: After screening and full text review, 7 studies met inclusion criteria (combined sample = 8,177 patients). Most studies (6/7) reported a significant relationship between pocket hematoma and all types of infection (OR = 6.9-24.98; p < 0.05). The proportion of wound infection among all types of infections was 61.5 - 100%.

Conclusions: Pocket hematoma is a significant risk factor for all types of infection, with the most frequent type of infection being wound infection.

Keywords: Cardiac resynchronization therapy; Implantable cardioverter defibrillator; Pacemaker; Pocket hematoma; Surgical site infection; Wound infection.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Defibrillators, Implantable / adverse effects*
  • Hematoma / complications*
  • Humans
  • Pacemaker, Artificial / adverse effects
  • Prosthesis-Related Infections
  • Risk Factors
  • Wound Infection / etiology*