Clinical Characteristics and Outcome of Infective Endocarditis
Involving Implantable Cardiac Devices

J 2012

Clinical Characteristics and Outcome of Infective Endocarditis Involving Implantable Cardiac Devices

ATHAN, Eugene, Vivian H CHU, Pierre TATTEVIN, Christine SELTON-SUTY, Phillip JONES et. al.

Basic information

Original name

Clinical Characteristics and Outcome of Infective Endocarditis Involving Implantable Cardiac Devices

Authors

Edition

JAMA-Journal of the American Medical Association, Chicago, USA, American Medical Association, 2012, 0098-7484

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30102 Immunology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 29.978

Organization unit

Central European Institute of Technology

UT WoS

000303147500026

Keywords in English

CARDIOVERTER-DEFIBRILLATOR INFECTION; PERMANENT PACEMAKER; VALVE ENDOCARDITIS; RISK-FACTORS; MANAGEMENT; DIAGNOSIS; MORTALITY; PROGRESS

Abstract

V originále

Context Infection of implantable cardiac devices is an emerging disease with significant morbidity, mortality, and health care costs. Objectives To describe the clinical characteristics and outcome of cardiac device infective endocarditis (CDIE) with attention to its health care association and to evaluate the association between device removal during index hospitalization and outcome. Design, Setting, and Patients Prospective cohort study using data from the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), conducted June 2000 through August 2006 in 61 centers in 28 countries. Patients were hospitalized adults with definite endocarditis as defined by modified Duke endocarditis criteria. Main Outcome Measures In-hospital and 1-year mortality. Results CDIE was diagnosed in 177 (6.4% [95% CI, 5.5%-7.4%]) of a total cohort of 2760 patients with definite infective endocarditis. The clinical profile of CDIE included advanced patient age (median, 71.2 years [interquartile range, 59.8-77.6]); causation by staphylococci (62 [35.0% {95% CI, 28.0%-42.5%}] Staphylococcus aureus and 56 [31.6% {95% CI, 24.9%-39.0%}] coagulase-negative staphylococci); and a high prevalence of health care-associated infection (81 [45.8% {95% CI, 38.3%-53.4%}]). There was coexisting valve involvement in 66 (37.3% [95% CI, 30.2%-44.9%]) patients, predominantly tricuspid valve infection (43/177 [24.3%]), with associated higher mortality. In-hospital and 1-year mortality rates were 14.7% (26/177 [95% CI, 9.8%-20.8%]) and 23.2% (41/177 [95% CI, 17.2%-30.1%]), respectively. Proportional hazards regression analysis showed a survival benefit at 1 year for device removal during the initial hospitalization (28/141 patients [19.9%] who underwent device removal during the index hospitalization had died at 1 year, vs 13/34 [38.2%] who did not undergo device removal; hazard ratio, 0.42 [95% CI, 0.22-0.82]). Conclusions Among patients with CDIE, the rate of concomitant valve infection is high, as is mortality, particularly if there is valve involvement. Early device removal is associated with improved survival at 1 year. JAMA. 2012;307(16):1727-1735

Citovat

ATHAN, Eugene, Vivian H CHU, Pierre TATTEVIN, Christine SELTON-SUTY, Phillip JONES, Christoph NABER, Jose M MIRO, Salvador NINOT, Nuria FERNANDEZ-HIDALGO, Emanuele DURANTE-MANGONI, Denis SPELMAN, Bruno HOEN, Tatjana LEJKO-ZUPANC, Enrico CECCHI, Franck THUNY, Margaret M HANNAN, Paul PAPPAS, Margaret HENRY, Vance G Jr FOWLER, Anna Lisa CROWLEY and Andrew WANG. Clinical Characteristics and Outcome of Infective Endocarditis Involving Implantable Cardiac Devices. JAMA-Journal of the American Medical Association. Chicago, USA: American Medical Association, 2012, vol. 307, No 16, p. 1727-1735. ISSN 0098-7484.

@article{1088643,
   author = {Athan, Eugene and Chu, Vivian H and Tattevin, Pierre and SeltonandSuty, Christine and Jones, Phillip and Naber, Christoph and Miro, Jose M and Ninot, Salvador and FernandezandHidalgo, Nuria and DuranteandMangoni, Emanuele and Spelman, Denis and Hoen, Bruno and LejkoandZupanc, Tatjana and Cecchi, Enrico and Thuny, Franck and Hannan, Margaret M and Pappas, Paul and Henry, Margaret and Fowler, Vance G Jr and Crowley, Anna Lisa and Wang, Andrew and Freiberger, Tomáš and Pol, Jiří and Mališová, Barbora},
   article_location = {Chicago, USA},
   article_number = {16},
   keywords = {CARDIOVERTER-DEFIBRILLATOR INFECTION; PERMANENT PACEMAKER; VALVE ENDOCARDITIS; RISK-FACTORS; MANAGEMENT; DIAGNOSIS; MORTALITY; PROGRESS},
   language = {eng},
   issn = {0098-7484},
   journal = {JAMA-Journal of the American Medical Association},
   title = {Clinical Characteristics and Outcome of Infective Endocarditis Involving Implantable Cardiac Devices},
   url = {http://jama.jamanetwork.com/article.aspx?articleid=1148195},
   volume = {307},
   year = {2012}
}

TY  - JOUR
ID  - 1088643
AU  - Athan, Eugene - Chu, Vivian H - Tattevin, Pierre - Selton-Suty, Christine - Jones, Phillip - Naber, Christoph - Miro, Jose M - Ninot, Salvador - Fernandez-Hidalgo, Nuria - Durante-Mangoni, Emanuele - Spelman, Denis - Hoen, Bruno - Lejko-Zupanc, Tatjana - Cecchi, Enrico - Thuny, Franck - Hannan, Margaret M - Pappas, Paul - Henry, Margaret - Fowler, Vance G Jr - Crowley, Anna Lisa - Wang, Andrew - Freiberger, Tomáš - Pol, Jiří - Mališová, Barbora
PY  - 2012
TI  - Clinical Characteristics and Outcome of Infective Endocarditis Involving Implantable Cardiac Devices
JF  - JAMA-Journal of the American Medical Association
VL  - 307
IS  - 16
SP  - 1727-1735
EP  - 1727-1735
PB  - American Medical Association
SN  - 00987484
KW  - CARDIOVERTER-DEFIBRILLATOR INFECTION
KW  - PERMANENT PACEMAKER
KW  - VALVE ENDOCARDITIS
KW  - RISK-FACTORS
KW  - MANAGEMENT
KW  - DIAGNOSIS
KW  - MORTALITY
KW  - PROGRESS
UR  - http://jama.jamanetwork.com/article.aspx?articleid=1148195
N2  - Context Infection of implantable cardiac devices is an emerging disease with significant morbidity, mortality, and health care costs. Objectives To describe the clinical characteristics and outcome of cardiac device infective endocarditis (CDIE) with attention to its health care association and to evaluate the association between device removal during index hospitalization and outcome. Design, Setting, and Patients Prospective cohort study using data from the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), conducted June 2000 through August 2006 in 61 centers in 28 countries. Patients were hospitalized adults with definite endocarditis as defined by modified Duke endocarditis criteria. Main Outcome Measures In-hospital and 1-year mortality. Results CDIE was diagnosed in 177 (6.4% [95% CI, 5.5%-7.4%]) of a total cohort of 2760 patients with definite infective endocarditis. The clinical profile of CDIE included advanced patient age (median, 71.2 years [interquartile range, 59.8-77.6]); causation by staphylococci (62 [35.0% {95% CI, 28.0%-42.5%}] Staphylococcus aureus and 56 [31.6% {95% CI, 24.9%-39.0%}] coagulase-negative staphylococci); and a high prevalence of health care-associated infection (81 [45.8% {95% CI, 38.3%-53.4%}]). There was coexisting valve involvement in 66 (37.3% [95% CI, 30.2%-44.9%]) patients, predominantly tricuspid valve infection (43/177 [24.3%]), with associated higher mortality. In-hospital and 1-year mortality rates were 14.7% (26/177 [95% CI, 9.8%-20.8%]) and 23.2% (41/177 [95% CI, 17.2%-30.1%]), respectively. Proportional hazards regression analysis showed a survival benefit at 1 year for device removal during the initial hospitalization (28/141 patients [19.9%] who underwent device removal during the index hospitalization had died at 1 year, vs 13/34 [38.2%] who did not undergo device removal; hazard ratio, 0.42 [95% CI, 0.22-0.82]). Conclusions Among patients with CDIE, the rate of concomitant valve infection is high, as is mortality, particularly if there is valve involvement. Early device removal is associated with improved survival at 1 year. JAMA. 2012;307(16):1727-1735
ER  -

ATHAN, Eugene, Vivian H CHU, Pierre TATTEVIN, Christine SELTON-SUTY, Phillip JONES, Christoph NABER, Jose M MIRO, Salvador NINOT, Nuria FERNANDEZ-HIDALGO, Emanuele DURANTE-MANGONI, Denis SPELMAN, Bruno HOEN, Tatjana LEJKO-ZUPANC, Enrico CECCHI, Franck THUNY, Margaret M HANNAN, Paul PAPPAS, Margaret HENRY, Vance G Jr FOWLER, Anna Lisa CROWLEY and Andrew WANG. Clinical Characteristics and Outcome of Infective Endocarditis Involving Implantable Cardiac Devices. \textit{JAMA-Journal of the American Medical Association}. Chicago, USA: American Medical Association, 2012, vol.~307, No~16, p.~1727-1735. ISSN~0098-7484.

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