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oai:recercat.cat:2445/1950642026-04-07T19:38:59Zcom_2072_1057col_2072_478825col_2072_478858col_2072_478917col_2072_478921

urn:hdl:2445/195064 Forty-Year Trends in Cardiac Implantable Electronic Device Infective Endocarditis Hernández Meneses, Marta Llopis Pérez, Jaime Sandoval, Elena Ninot, Salvador Almela, M. (Manel) Falces Salvador, Carles Pericàs, Juan M. Vidal, Bàrbara Perissinotti, Andrés Marco Reverté, Francesc Mestres, Carlos A. Pare i Bardera, J. Carles García de la Mària, Cristina Cuervo Requena, Guillermo Quintana, Eduard Tolosana, José M. (José María) Moreno Camacho, Ma. Asunción Miró Meda, José M. (José María), 1956- Hospital Clinic Infective Endocarditis Team Investigators Pronòstic mèdic Epidemiologia Endocarditis Prognosis Epidemiology Endocarditis Background: Studies investigating cardiac implantable electronic device infective endocarditis (CIED-IE) epidemiological changes and prognosis over long periods of time are lacking. Methods: Retrospective single cardiovascular surgery center cohort study of definite CIED-IE episodes between 1981-2020. A comparative analysis of two periods (1981-2000 vs 2001-2020) was conducted to analyze changes in epidemiology and outcome over time. Results: One-hundred and thirty-eight CIED-IE episodes were diagnosed: 25 (18%) first period and 113 (82%) second. CIED-IE was 4.5 times more frequent in the second period, especially in implantable cardiac defibrillators. Age (63 [53-70] vs 71 [63-76] years, P < .01), comorbidities (CCI 3.0 [2-4] vs 4.5 [3-6], P > .01), nosocomial infections (4% vs 15.9%, P = .02) and transfers from other centers (8% vs 41.6%, P < .01) were significantly more frequent in the second period, as were methicillin-resistant coagulase-negative staphylococcal (MR-CoNS) (0% vs 13.3%, P < .01) and Enterococcus spp. (0% vs 5.3%, P = .01) infections, pulmonary embolism (0% vs 10.6%, P < .01) and heart failure (12% vs 28.3%, p < .01). Second period surgery rates were lower (96% vs 87.6%, P = .09), and there were no differences in in-hospital (20% vs 11.5%, P = .11) and one-year mortalities (24% vs 15%, P = .33), or relapses (8% vs 5.3%, P = 0.65). Multivariate analysis showed Charlson index (hazard ratios [95% confidence intervals]; 1.5 [1.16-1.94]) and septic shock (23.09 [4.57-116.67]) were associated with a worse prognosis, whereas device removal (0.11 [.02-.57]), transfers (0.13 [.02-0.95]), and second-period diagnosis (0.13 [.02-.71]) were associated with better one-year outcomes. Conclusions: CIED-IE episodes increased more than four-fold during last 40 years. Despite CIED-IE involved an older population with more comorbidities, antibiotic-resistant MR-CoNS, and complex devices, one-year survival improved. 2023-03-10T17:31:31Z 2023-03-10T17:31:31Z 2022-10-14 2023-03-10T17:31:31Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a: https://doi.org/10.1093/ofid/ofac547 Open Forum Infectious Diseases, 2022, vol. 9, num. 11, p. 1-11 https://doi.org/10.1093/ofid/ofac547 cc-by-nc-nd (c) Hernández-Meneses, Marta et al., 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess Oxford University Press Articles publicats en revistes (Genètica, Microbiologia i Estadística)