ABSTRACT

Introduction

Infections are complications of Cardiac Implantable Electronic Device (CIED) procedures, associated with high mortality (20–25% at 1 year), long hospitalizations (23–30 days), and high costs for health-care systems (often higher than 30.000 €). The incidence rates are around 1–4%. Prevention strategies appear to be the best approach for minimizing the occurrence of CIED infections, but in real-world, the recommendations for the best practices are not always followed. Among the recommended preventive measures, the antibacterial envelope has proven to be effective in reducing CIED-related infections.

Areas covered

Published studies investigate the role of antibacterial envelopes in infection prevention and the use of infection risk scores to select high-risk patients undergoing CIED implantation/replacement who can benefit from additional preventive measures.

Expert opinion

A proficient selection of the best candidates for the antibacterial envelope can be the basis for reducing the healthcare system’s costs, in line with the principles of cost-effectiveness. Risk scores have been developed to select patients at high risk of CIED infections and their use appears simple and more complete than individual factors alone. Among them, the PADIT score seems to be effective in selecting patients eligible for antibacterial envelope insertion, with a good cost-effectiveness profile.

中文翻译：

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与心脏植入式电子设备相关的疾病负担和感染成本

摘要

介绍

感染是心脏植入电子设备 (CIED) 手术的并发症，与高死亡率（1 年 20-25%）、住院时间长（23-30 天）和医疗保健系统成本高（通常高于 30.000 欧元）相关）。发病率约为 1-4%。预防策略似乎是尽量减少 CIED 感染发生的最佳方法，但在现实世界中，并不总是遵循最佳实践的建议。在推荐的预防措施中，抗菌包膜已被证明可有效减少 CIED 相关感染。

涵盖的领域

已发表的研究调查了抗菌包膜在预防感染中的作用，以及使用感染风险评分来选择接受 CIED 植入/更换的高风险患者，这些患者可以从额外的预防措施中受益。

专家意见

根据成本效益原则，熟练选择抗菌包膜的最佳候选者可以成为降低医疗保健系统成本的基础。已经开发了风险评分来选择 CIED 感染高风险的患者，并且它们的使用似乎比单独的个体因素更简单和更完整。其中，PADIT 评分似乎可以有效选择适合插入抗菌信封的患者，具有良好的成本效益。