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Bundled skin antiseptic preparation for complex cardiac implantable electronic device infection: a propensity-score matching cohort study.
Journal of Hospital Infection ( IF 6.9 ) Pub Date : 2019-08-23 , DOI: 10.1016/j.jhin.2019.08.015
H.-C. Chen , W.-C. Lee , Y.-L. Chen , T.-H. Tsai , K.-L. Pan , Y.-S. Lin , M.-C. Chen

BACKGROUND Cardiac implantable electronic device (CIED) infection, a major complication of a CIED implant procedure, can prolong hospitalization and cause mortality. AIM To evaluate the efficacy of a bundled skin antiseptic preparation for preventing infection after implantation of a complex CIED. METHODS This study analysed 1163 consecutive patients who had received a bundled skin antiseptic preparation before CIED implantation from July 2012 to December 2017. According to the complexity of the CIED implant procedure, the patients were divided into a complex CIED group (N = 370) and a non-complex CIED group (N = 793). A complex procedure was defined as a pacemaker replacement, implantation of implantable cardioverter defibrillator and cardiac resynchronization therapy, device upgrade, or lead revision. FINDINGS During a mean follow-up of 2.9 ± 1.7 years, CIED infection developed in 15 patients (1.3%), and the incidence of minor and major infection was 1.1% and 0.2%, respectively. The incidence of CIED infection did not significantly differ between the complex CIED group and the non-complex CIED group (1.1% vs 1.4%, respectively; non-significant). Multivariate analysis indicated that procedural complexity was not an independent predictor of CIED infection. After 2:1 propensity score matching, the matched non-complex CIED group and the matched complex CIED group still showed no significant difference in the incidence of CIED infection. CONCLUSION Bundled skin antiseptic preparation is an effective and widely applicable strategy for decreasing infection risk after a complex CIED implantation.

中文翻译:

复杂心脏植入式电子设备感染的皮肤消毒剂捆绑包装:倾向得分匹配队列研究。

背景技术心脏植入式电子设备(CIED)感染是CIED植入程序的主要并发症,可能会延长住院时间并导致死亡。目的评估捆绑的皮肤消毒剂预防复杂CIED植入后感染的功效。方法:本研究分析了2012年7月至2017年12月在CIED植入前接受捆绑皮肤消毒制剂的1163例连续患者。根据CIED植入程序的复杂性,将患者分为复杂的CIED组(N = 370)和对照组。一个非复杂的CIED组(N = 793)。复杂的程序定义为起搏器更换,植入式心脏复律除颤器的植入和心脏再同步治疗,设备升级或导线修订。结果在平均随访2次中。在9±1.7年中,有15例患者(1.3%)发生了CIED感染,轻度和重度感染的发生率分别为1.1%和0.2%。在复杂的CIED组和非复杂的CIED组之间,CIED感染的发生率没有显着差异(分别为1.1%和1.4%;无显着性)。多变量分析表明,程序复杂性不是CIED感染的独立预测因素。在2:1的倾向得分匹配之后,匹配的非复杂CIED组和匹配的复杂CIED组在CIED感染的发生率上仍然没有显着差异。结论捆绑的皮肤消毒剂是一种有效且广泛应用的策略,可降低复杂的CIED植入后的感染风险。轻度和重度感染的发生率分别为1.1%和0.2%。在复杂的CIED组和非复杂的CIED组之间,CIED感染的发生率没有显着差异(分别为1.1%和1.4%;无显着性)。多变量分析表明,程序复杂性不是CIED感染的独立预测因素。在2:1的倾向得分匹配之后,匹配的非复杂CIED组和匹配的复杂CIED组在CIED感染的发生率上仍然没有显着差异。结论捆绑的皮肤消毒剂是一种有效且广泛应用的策略,可降低复杂的CIED植入后的感染风险。轻度和重度感染的发生率分别为1.1%和0.2%。在复杂的CIED组和非复杂的CIED组之间,CIED感染的发生率没有显着差异(分别为1.1%和1.4%;无显着性)。多变量分析表明,程序复杂性不是CIED感染的独立预测因素。在2:1的倾向得分匹配之后,匹配的非复杂CIED组和匹配的复杂CIED组在CIED感染的发生率上仍然没有显着差异。结论捆绑的皮肤消毒剂是一种有效且广泛应用的策略,可降低复杂的CIED植入后的感染风险。在复杂的CIED组和非复杂的CIED组之间,CIED感染的发生率没有显着差异(分别为1.1%和1.4%;无显着性)。多变量分析表明,程序复杂性不是CIED感染的独立预测因素。在2:1的倾向得分匹配之后,匹配的非复杂CIED组和匹配的复杂CIED组在CIED感染的发生率上仍然没有显着差异。结论捆绑的皮肤消毒剂是一种有效且广泛应用的策略,可降低复杂的CIED植入后的感染风险。在复杂的CIED组和非复杂的CIED组之间,CIED感染的发生率没有显着差异(分别为1.1%和1.4%;无显着性)。多变量分析表明,程序复杂性不是CIED感染的独立预测因素。在2:1的倾向得分匹配之后,匹配的非复杂CIED组和匹配的复杂CIED组在CIED感染的发生率上仍然没有显着差异。结论捆绑的皮肤消毒剂是一种有效且广泛应用的策略,可降低复杂的CIED植入后的感染风险。配对的非复杂CIED组和配对的复杂CIED组在CIED感染的发生率上仍无显着差异。结论捆绑的皮肤消毒剂是一种有效且广泛应用的策略,可降低复杂的CIED植入后的感染风险。配对的非复杂CIED组和配对的复杂CIED组在CIED感染的发生率上仍无显着差异。结论捆绑的皮肤消毒剂是一种有效且广泛应用的策略,可降低复杂的CIED植入后的感染风险。
更新日期:2019-08-25
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