Incidence and costs of cardiac device infections: retrospective analysis using German health claims data.

AIM Estimate incidence and costs of cardiac device infections (CDIs) in Germany. MATERIALS & METHODS Patients had an implantable cardioverter defibrillator implanted over 2010-2013 and were followed to December 2014 using German health insurance claims data. A case-controlled analysis was performed using propensity score matching methods. RESULTS Risk of CDI 12 months post-implant was 3.4% overall, either 2.9% for de novo procedures versus 4.4% for replacement procedures. Mean 3-year incremental expenditure per patient for patients with CDI compared with controls was €31,493 for de novo implant patients and €33,777 for replacement patients. Mean incremental expenditure was €59,419 per patient with a major infection. CONCLUSION CDIs are highly expensive to manage, reinforcing the need for strategies to reduce their occurrence.

[1]  M. Shoda,et al.  2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction. , 2017, Heart rhythm.

[2]  Dhanunjaya R. Lakkireddy,et al.  Cardiac Implantable Electronic Device‐Related Infection and Extraction Trends in the U.S. , 2017, Pacing and clinical electrophysiology : PACE.

[3]  Hans Eiskjær,et al.  Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure. , 2016, The New England journal of medicine.

[4]  D. Arnar,et al.  Access to and clinical use of cardiac implantable electronic devices and interventional electrophysiological procedures in the European Society of Cardiology Countries: 2016 Report from the European Heart Rhythm Association. , 2016, Europace.

[5]  A. Greenspon,et al.  Incidence, Treatment Intensity, and Incremental Annual Expenditures for Patients Experiencing a Cardiac Implantable Electronic Device Infection: Evidence From a Large US Payer Database 1-Year Post Implantation , 2016, Circulation. Arrhythmia and electrophysiology.

[6]  B. Iung,et al.  2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). , 2015, European heart journal.

[7]  M. Falagas,et al.  Risk factors for cardiac implantable electronic device infection: a systematic review and meta-analysis. , 2015, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[8]  B. Prendergast,et al.  Guidelines for the diagnosis, prevention and management of implantable cardiac electronic device infection. Report of a joint Working Party project on behalf of the British Society for Antimicrobial Chemotherapy (BSAC, host organization), British Heart Rhythm Society (BHRS), British Cardiovascular S , 2015, The Journal of antimicrobial chemotherapy.

[9]  P. Lambiase,et al.  A simple infection-control protocol to reduce serious cardiac device infections. , 2014, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[10]  Gilbert Habib,et al.  Long-term outcomes following infection of cardiac implantable electronic devices: a prospective matched cohort study , 2012, Heart.

[11]  M. Schalij,et al.  Cardiac device infections are associated with a significant mortality risk. , 2012, Heart rhythm.

[12]  C. Henrikson,et al.  Mortality and cost associated with cardiovascular implantable electronic device infections. , 2011, Archives of internal medicine.

[13]  J. Nielsen,et al.  Infection after pacemaker implantation: infection rates and risk factors associated with infection in a population-based cohort study of 46299 consecutive patients , 2011, European heart journal.

[14]  Andres Hilfiker,et al.  Economic implications of infections of implantable cardiac devices in a single institution. , 2010, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[15]  Michael L. Johnson,et al.  Good research practices for comparative effectiveness research: analytic methods to improve causal inference from nonrandomized studies of treatment effects using secondary data sources: the ISPOR Good Research Practices for Retrospective Database Analysis Task Force Report--Part III. , 2009, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[16]  S. A. D’Orio Nishioka,et al.  Efficacy of Antibiotic Prophylaxis Before the Implantation of Pacemakers and Cardioverter-Defibrillators: Results of a Large, Prospective, Randomized, Double-Blinded, Placebo-Controlled Trial , 2009, Circulation. Arrhythmia and electrophysiology.

[17]  Marco Caliendo,et al.  Some Practical Guidance for the Implementation of Propensity Score Matching , 2005, SSRN Electronic Journal.

[18]  P. Ponikowski,et al.  2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure , 2016 .

[19]  Andrea Mazzanti,et al.  [2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death]. , 2015, Kardiologia polska.

[20]  M. Messier,et al.  Prevalence and risk factors related to infections of cardiac resynchronization therapy devices. , 2010, European heart journal.