Cardiac implantable electronic device (CIED) infections are expensive and associated with prolonged hospitalisation: UK Retrospective Observational Study
Cardiac implantable electronic device (CIED) infections are expensive and associated with prolonged hospitalisation: UK Retrospective Observational Study
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DOI：
10.1371/journal.pone.0206611
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发表时间：
2019-01-02
期刊：
影响因子：
3.7
通讯作者：
Zaidi, Amir
中科院分区：
文献类型：
--
作者：
Ahmed, Fozia Zahir;Fullwood, Catherine;Zaidi, Amir
背景概述美国境外治疗心脏植入式电子设备 (CIED) 感染的财务成本的报告有限。本研究旨在确定英国大型三级转诊中心 CIED 感染的平均治疗费用，并比较 CIED 感染管理中公认的不同治疗途径的费用（早期与延迟再植入）。 方法我们回顾性分析了连续接受感染 CIED 摘除和心脏再同步治疗（CRT-D [带除颤器]、CRT-P [带起搏器]）、植入式治疗的患者的费用和住院时间 (LOS) 数据。心脏复律除颤器 (ICD) 和永久起搏器 (PPM)。 结果 2013 年 1 月至 2015 年 3 月期间，可获得 84 名患者的完整数据（18 名 [21.4%] CRT-D、24 名 [28.6%] ICD 和 42 名 [50.0%] PPM）。当考虑所有病例时，感染成本从 5,139 英镑 (PPM) 到 24,318 英镑 (CRT-D) 不等。考虑不同的治疗策略； 41 名 (48.8%) 在同一入院期间接受了 CIED 拔牙和再植入（早期再植入策略 (ER)）。43 名 (51.2%) 接受了拔牙，但随后出院回家重新入院进行日间再植入（延迟再植入策略 (DR)）。与 ER 相比，DR 中的中位 LOS 显着缩短（5.0 天与 18.0 天，p）
BackgroundThere are limited reports outlining the financial cost of treating cardiac implantable electronic device (CIED) infection outside the United States. This study aimed to determine the average treatment cost of CIED infection in a large UK tertiary referral centre and compared costs of different treatment pathways that are recognised in the management of CIED infection (early versus delayed re-implantation).MethodsWe retrospectively analysed cost and length of stay (LOS) data for consecutive patients undergoing infected CIED extraction with cardiac resynchronization therapy (CRT-D [with defibrillator], CRT-P [with pacemaker]), implantable cardioverter-defibrillators (ICDs) and permanent pacemakers (PPMs).ResultsBetween January 2013 and March 2015, complete data was available for 84 patients (18 [21.4%] CRT-D, 24 [28.6%] ICDs and 42 [50.0%] PPMs). When all cases were considered the cost of infection ranged from pound 5,139 (PPM) to pound 24,318 (CRT-D). Considering different treatment strategies; 41 (48.8%) underwent CIED extraction and re-implantation during the same admission (early re-implant strategy (ER). 43 (51.2%) underwent extraction, but were then discharged home to be re-admitted for day-case re-implantation (delayed re-implant strategy (DR)). Median LOS was significantly shorter in DR compared to ER (5.0 vs. 18.0 days, p