Health and Economic Outcomes Associated with Use of an Antimicrobial Envelope as a Standard of Care for Cardiac Implantable Electronic Device Implantation

Shariff, Nasir; Eby, E.; Adelstein, Evan; Jain, Sandeep; Shalaby, Alaa; Saba, Samir; Wang, Norman C.; Schwartzman, David

doi:10.1111/jce.12684

Cited by 78 publications

(79 citation statements)

References 18 publications

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“…A Medicare-derived database series of 5,817 patients who were treated in 2007 estimated the cost of CIED infection to be as high as USD 53,349 per infection [14]. A recent study on 19 patients with CIED infections at a single institution estimated the mean cost to be USD 54,926 ± 11,374 per patient [15]. The mean length of stay for hospitalization in this study was 13 ± 11 days (range 1-45 days), and the mortality rate was 15.7%.…”

Section: Discussionmentioning

confidence: 99%

Cost of Deep Brain Stimulation Infection Resulting in Explantation

Chen

Mirzadeh²,

Lambert³

et al. 2017

Stereotact Funct Neurosurg

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Background: Deep brain stimulation (DBS) hardware infection is a serious complication, often resulting in multiple hardware salvage attempts, hospitalizations, and long-term antibiotic therapy. Objectives: We aimed to quantify the costs of DBS hardware-related infections in patients undergoing eventual device explantation. Methods: Of 362 patients who underwent 530 electrode placements (1 January 2010 to 30 December 2014), 16 (4.4%) had at least 2 hardware salvage procedures. Most (n = 15 [93.8%]) required complete explantation due to recurrent infection. Financial data (itemized hospital and physician costs) were available for 13 patients and these were analyzed along with the demographic data. Results: Each patient underwent 1-5 salvage procedures (mean 2.5 ± 1.4; median 2). The mean total cost for a patient undergoing the median number of revisions (n = 2), device explantation, and subsequent reimplantation after infection clearance was USD 75,505; just over half this cost (54.2% [USD 40,960]) was attributable to reimplantation, and nearly one-third (28.9% [USD 21,816]) was attributable to hardware salvage procedures. Operating-room costs were the highest cost category for hardware revision and explantation. Medical and surgical supplies accounted for the highest reimplantation cost. Conclusions: DBS infection incurs significant health care costs associated with hardware salvage attempts, explantation, and reimplantation. The highest cost categories are operating-room services and medical and surgical supplies.

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Section: Discussionmentioning

confidence: 99%

Cost of Deep Brain Stimulation Infection Resulting in Explantation

Chen

Mirzadeh²,

Lambert³

et al. 2017

Stereotact Funct Neurosurg

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“…5) [17]. The biocompatible mesh is coated with antibiotics that elute (dissolve) within an approximately 7-day period.…”

Section: New Technologies To Reduce the Risk Of Cied Infectionmentioning

confidence: 99%

New horizon for infection prevention technology and implantable device

Kondo

Ueda

Kobayashi

et al. 2016

Journal of Arrhythmia

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There has been a significant increase in the number of patients receiving cardiovascular implantable electronic devices (CIED) over the last two decades. CIED infection represents a serious complication after CIED implantation and is associated with significant morbidity and mortality. Recently, newly advanced technologies have offered attractive and suitable therapeutic alternatives. Notably, the leadless pacemaker and anti-bacterial envelope decrease the potential risk of CIED infection and the resulting mortality, when it does occur. A completely subcutaneous implantable cardioverter defibrillator is also an alternative to the transvenous implantable cardioverter defibrillator (ICD), as it does not require implantation of any transvenous or epicardial leads. Among the patients who require ICD removal and subsequent antibiotics secondary to infection, the wearable cardioverter defibrillator represents an alternative approach to inpatient monitoring for the prevention of sudden cardiac death. In this review paper, we aimed to introduce the advanced technologies and devices for prevention of CIED infection.

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“…We are pleased to respond to the thoughtful letter by Aryana et al . in regard to our recent publication in JCE . For clarity, note that although the analysis encompassed CIED implantations over a 28‐month period, the outcome of interest (incidence of CIED infection) was limited to the 6‐month post‐implantation interval.…”

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confidence: 99%

Shariff

Eby

Adelstein

et al. 2015

Cardiovasc electrophysiol

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