CIED-Related Infections, Costs Rising

The use of cardiac implantable electronic devices (CIED) is accompanied by an increase in device-related infections, especially for pacemakers, and the cost of treating those infections, length of stay, and mortality within 15 months of the procedure has been rising, researchers say.

Additionally, infections related to these devices provoked lengths of stay that were between 9.4 and 18.2 days longer than lengths of stay for patients who did not have infections.

Those were the findings from Muhammad R. Sohail, MD, of the Mayo Clinic College of Medicine in Rochester and colleagues at Johns Hopkins University, Catholic University of America and others. The report was published in Monday's Archives of Internal Medicine.

The researchers looked at a Medicare database of 200,219 fee-for-service patients admitted to a hospital during the 2007 calendar year for implantation, replacement, or revision of a cardiac device.

They found 5,817 developed an infection, which was associated with significant increases in adjusted admission mortality between 4.6% and 11.3%, and long-term mortality was 26.5% to 35.1% depending on the type of implant device.

In patients who developed infection, the total costs of admission were $28,676 to $53,349, depending on the device, an increase of between $14,360 and $16,498 per implant. Intensive care which was often required, and enhanced pharmacy services, made up 40% of the added cost.

Pacemakers seemed to carry the highest risk of infection, compared with implantable cardioverter-defibrillators or cardiac resynchronization therapy/defibrillator devices, the other types of CIEDs studied.