Predictors of mortality and outcomes in transvenous lead extraction for systemic and local infection cohorts

Justin Gould; Magdalena Klis; Bradley Porter; Baldeep S. Sidhu; Benjamin J. Sieniewicz; Steven E. Williams; Thomas Teall; Jessica Webb; Anoop Shetty; Jaswinder Gill; Christopher A. Rinaldi

doi:10.1111/pace.13542

Predictors of mortality and outcomes in transvenous lead extraction for systemic and local infection cohorts

Justin Gould^*, Magdalena Klis, Bradley Porter, Baldeep S. Sidhu, Benjamin J. Sieniewicz, Steven E. Williams, Thomas Teall, Jessica Webb, Anoop Shetty, Jaswinder Gill, Christopher A. Rinaldi

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

25 Citations (Scopus)

Abstract

Background: Transvenous lead extraction (TLE) may be necessary due to infective and noninfective indications. We aim to identify predictors of 30-day mortality and risk factors between infective versus noninfective groups and systemic versus local infection subgroups. Methods: A total of 925 TLEs between October 2000 and December 2016 were prospectively collected and dichotomized (infective group n = 505 vs noninfective group n = 420 and systemic infection n = 164 vs local infection n = 341). Results: All-cause major complication including deaths was significantly higher (5.1%, n = 26 vs 1.2%, n = 5, P = 0.001) as well as 30-day mortality (4.0%, n = 20 vs 0.2%, n = 1, P < 0.001) in the infective group compared to the noninfective group. Both subgroups (systemic vs local infection) were balanced for demographics. All-cause major complication including deaths was significantly higher (9.1%, n = 15 vs 3.2%, n = 11, P = 0.008) as well as all-cause 30-day mortality (7.9%, n = 13 vs 2.1%, n = 7, P = 0.003) in the systemic infection subgroup compared to the local infection subgroup. Conclusion: Patients undergoing TLE for infective indications are at greater risk of 30-day all-cause mortality compared to noninfective patients. Patients undergoing TLE for systemic infective indications are at greater risk of 30-day all-cause mortality compared to patients with local infection. Renal impairment, systemic infection, and elevated preprocedure C-reactive protein are independent predictors of 30-day all-cause mortality in patients undergoing TLE for an infective indication.

Original language	English
Pages (from-to)	73-84
Number of pages	12
Journal	PACE - Pacing and Clinical Electrophysiology
Volume	42
Issue number	1
DOIs	https://doi.org/10.1111/pace.13542
Publication status	Published - 1 Jan 2019

Keywords

cardiac implantable electronic device infection
device complications
local versus systemic infection
systemic versus local infection
transvenous lead extraction

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10.1111/pace.13542

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title = "Predictors of mortality and outcomes in transvenous lead extraction for systemic and local infection cohorts",

abstract = "Background: Transvenous lead extraction (TLE) may be necessary due to infective and noninfective indications. We aim to identify predictors of 30-day mortality and risk factors between infective versus noninfective groups and systemic versus local infection subgroups. Methods: A total of 925 TLEs between October 2000 and December 2016 were prospectively collected and dichotomized (infective group n = 505 vs noninfective group n = 420 and systemic infection n = 164 vs local infection n = 341). Results: All-cause major complication including deaths was significantly higher (5.1%, n = 26 vs 1.2%, n = 5, P = 0.001) as well as 30-day mortality (4.0%, n = 20 vs 0.2%, n = 1, P < 0.001) in the infective group compared to the noninfective group. Both subgroups (systemic vs local infection) were balanced for demographics. All-cause major complication including deaths was significantly higher (9.1%, n = 15 vs 3.2%, n = 11, P = 0.008) as well as all-cause 30-day mortality (7.9%, n = 13 vs 2.1%, n = 7, P = 0.003) in the systemic infection subgroup compared to the local infection subgroup. Conclusion: Patients undergoing TLE for infective indications are at greater risk of 30-day all-cause mortality compared to noninfective patients. Patients undergoing TLE for systemic infective indications are at greater risk of 30-day all-cause mortality compared to patients with local infection. Renal impairment, systemic infection, and elevated preprocedure C-reactive protein are independent predictors of 30-day all-cause mortality in patients undergoing TLE for an infective indication.",

keywords = "cardiac implantable electronic device infection, device complications, local versus systemic infection, systemic versus local infection, transvenous lead extraction",

author = "Justin Gould and Magdalena Klis and Bradley Porter and Sidhu, {Baldeep S.} and Sieniewicz, {Benjamin J.} and Williams, {Steven E.} and Thomas Teall and Jessica Webb and Anoop Shetty and Jaswinder Gill and Rinaldi, {Christopher A.}",

year = "2019",

month = jan,

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doi = "10.1111/pace.13542",

language = "English",

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journal = "PACE - Pacing and Clinical Electrophysiology",

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T1 - Predictors of mortality and outcomes in transvenous lead extraction for systemic and local infection cohorts

AU - Gould, Justin

AU - Klis, Magdalena

AU - Porter, Bradley

AU - Sidhu, Baldeep S.

AU - Sieniewicz, Benjamin J.

AU - Williams, Steven E.

AU - Teall, Thomas

AU - Webb, Jessica

AU - Shetty, Anoop

AU - Gill, Jaswinder

AU - Rinaldi, Christopher A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Transvenous lead extraction (TLE) may be necessary due to infective and noninfective indications. We aim to identify predictors of 30-day mortality and risk factors between infective versus noninfective groups and systemic versus local infection subgroups. Methods: A total of 925 TLEs between October 2000 and December 2016 were prospectively collected and dichotomized (infective group n = 505 vs noninfective group n = 420 and systemic infection n = 164 vs local infection n = 341). Results: All-cause major complication including deaths was significantly higher (5.1%, n = 26 vs 1.2%, n = 5, P = 0.001) as well as 30-day mortality (4.0%, n = 20 vs 0.2%, n = 1, P < 0.001) in the infective group compared to the noninfective group. Both subgroups (systemic vs local infection) were balanced for demographics. All-cause major complication including deaths was significantly higher (9.1%, n = 15 vs 3.2%, n = 11, P = 0.008) as well as all-cause 30-day mortality (7.9%, n = 13 vs 2.1%, n = 7, P = 0.003) in the systemic infection subgroup compared to the local infection subgroup. Conclusion: Patients undergoing TLE for infective indications are at greater risk of 30-day all-cause mortality compared to noninfective patients. Patients undergoing TLE for systemic infective indications are at greater risk of 30-day all-cause mortality compared to patients with local infection. Renal impairment, systemic infection, and elevated preprocedure C-reactive protein are independent predictors of 30-day all-cause mortality in patients undergoing TLE for an infective indication.

AB - Background: Transvenous lead extraction (TLE) may be necessary due to infective and noninfective indications. We aim to identify predictors of 30-day mortality and risk factors between infective versus noninfective groups and systemic versus local infection subgroups. Methods: A total of 925 TLEs between October 2000 and December 2016 were prospectively collected and dichotomized (infective group n = 505 vs noninfective group n = 420 and systemic infection n = 164 vs local infection n = 341). Results: All-cause major complication including deaths was significantly higher (5.1%, n = 26 vs 1.2%, n = 5, P = 0.001) as well as 30-day mortality (4.0%, n = 20 vs 0.2%, n = 1, P < 0.001) in the infective group compared to the noninfective group. Both subgroups (systemic vs local infection) were balanced for demographics. All-cause major complication including deaths was significantly higher (9.1%, n = 15 vs 3.2%, n = 11, P = 0.008) as well as all-cause 30-day mortality (7.9%, n = 13 vs 2.1%, n = 7, P = 0.003) in the systemic infection subgroup compared to the local infection subgroup. Conclusion: Patients undergoing TLE for infective indications are at greater risk of 30-day all-cause mortality compared to noninfective patients. Patients undergoing TLE for systemic infective indications are at greater risk of 30-day all-cause mortality compared to patients with local infection. Renal impairment, systemic infection, and elevated preprocedure C-reactive protein are independent predictors of 30-day all-cause mortality in patients undergoing TLE for an infective indication.

KW - cardiac implantable electronic device infection

KW - device complications

KW - local versus systemic infection

KW - systemic versus local infection

KW - transvenous lead extraction

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U2 - 10.1111/pace.13542

DO - 10.1111/pace.13542

M3 - Article

C2 - 30411817

AN - SCOPUS:85056997094

SN - 0147-8389

VL - 42

SP - 73

EP - 84

JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

IS - 1

ER -

Predictors of mortality and outcomes in transvenous lead extraction for systemic and local infection cohorts

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