Nicolas Clémenty1, Phuong Lien Carion2, Lucie de Léotoing3, Ludovic Lamarsalle3, Fanny Wilquin-Bequet2, Benedict Brown4, Koen J P Verhees5, Jérôme Fernandes6, Jean-Claude Deharo7. 1. Centre Hospitalier Régional Universitaire de Tours, Boulevard Tonnellé, Tours, France. 2. Medtronic France, Quai Alphonse le Gallo 27, Boulogne-Billancourt, France. 3. HEVA, Health Economics and Outcomes Research, Avenue Thiers 186, Lyon, France. 4. Medtronic International Trading Sàrl, Route du Molliau 31, Tolochenaz, Switzerland. 5. Medtronic, Bakken Research Center (BRC), Endepolsdomein 5, GW, Maastricht, The Netherlands. 6. OC Santé, Centre Médical Odysseum, Avenue Nina Simone 194, CS, Montpellier, France. 7. Centre Hospitalier Universitaire (CHU), Hôpital de la Timone, Medical School of Marseille, Department of Cardiology, Rue Saint-Pierre 264, Marseille, France.
Abstract
Aims: This study assessed the contemporary occurrence of cardiac device infections (CDIs) following implantation in French hospitals and estimated associated costs. Methods and Results: A retrospective analysis was conducted on the French National Hospital Database (PMSI). Patients with a record of de novo cardiac implantable electronic device (CIED) implantation or replacement interventions in France in 2012 were identified and followed until the end of 2015. Cardiac device infections (CDIs) were identified based on coding using the French classification for procedures [Classification Commune des Actes Médicaux (CCAM)] and International Classification of Diseases (ICD-10). Associated costs were estimated based on direct costs from the perspective of the French social security system. In total 78 267 CIED patients (72% de novo implants) were identified (15% defibrillators; 84% pacemakers). The 36-month infection rate associated with de novo defibrillator-only implants, as well as for cardiac resynchronisation therapy - defibrillators (CRT-Ds) was 1.6%. The CDI risk was 2.9% and 3.9% for replacement ICDs and CRT-Ds. Infection rates were lower for de novo single-chamber pacemaker (SCP)/dual-chamber pacemaker (DCP) (0.5%) and cardiac resynchronisation therapy - pacemaker (CRT-P) implants (1.0%), while for replacement procedures the risk increased to 1.4% (SCP/DCP) and 1.3% (CRT-P). Mean infection-related costs over 24 months were €20 623 and €23 234 for CDIs associated with replacement and de novo procedures, and overall costs were not significantly different between pacemaker and defibrillator patients. Conclusion: Cardiac device infections in France are associated with substantial costs, when considering inpatient hospitalizations. Strategies to minimize the rate of CIED infection should be a priority for health care providers and payers.
Aims: This study assessed the contemporary occurrence of cardiac device infections (CDIs) following implantation in French hospitals and estimated associated costs. Methods and Results: A retrospective analysis was conducted on the French National Hospital Database (PMSI). Patients with a record of de novo cardiac implantable electronic device (CIED) implantation or replacement interventions in France in 2012 were identified and followed until the end of 2015. Cardiac device infections (CDIs) were identified based on coding using the French classification for procedures [Classification Commune des Actes Médicaux (CCAM)] and International Classification of Diseases (ICD-10). Associated costs were estimated based on direct costs from the perspective of the French social security system. In total 78 267 CIED patients (72% de novo implants) were identified (15% defibrillators; 84% pacemakers). The 36-month infection rate associated with de novo defibrillator-only implants, as well as for cardiac resynchronisation therapy - defibrillators (CRT-Ds) was 1.6%. The CDI risk was 2.9% and 3.9% for replacement ICDs and CRT-Ds. Infection rates were lower for de novo single-chamber pacemaker (SCP)/dual-chamber pacemaker (DCP) (0.5%) and cardiac resynchronisation therapy - pacemaker (CRT-P) implants (1.0%), while for replacement procedures the risk increased to 1.4% (SCP/DCP) and 1.3% (CRT-P). Mean infection-related costs over 24 months were €20 623 and €23 234 for CDIs associated with replacement and de novo procedures, and overall costs were not significantly different between pacemaker and defibrillator patients. Conclusion:Cardiac device infections in France are associated with substantial costs, when considering inpatient hospitalizations. Strategies to minimize the rate of CIED infection should be a priority for health care providers and payers.
Authors: Paola Anna Erba; Francesco Bartoli; Martina Sollini; Berchiolli Raffaella; Roberta Zanca; Esposito Enrica; Elena Lazzeri Journal: Curr Cardiol Rep Date: 2022-06-13 Impact factor: 3.955
Authors: Mikhael F El-Chami; Jens Brock Johansen; Amir Zaidi; Svein Faerestrand; Dwight Reynolds; Javier Garcia-Seara; Jacques Mansourati; Jean-Luc Pasquie; Hugh Thomas McElderry; Paul R Roberts; Kyoko Soejima; Kurt Stromberg; Jonathan P Piccini Journal: J Cardiovasc Electrophysiol Date: 2019-01-28