Risk Scores for Cardiac Implantable Electronic Device Infection: Which One to Believe In?
Abstract
:1. Introduction
2. Risk Factors for CIED Infections
3. Risk Scores
3.1. PADIT
3.2. SHARIFF
3.3. KOLEK
3.4. MITTAL
3.5. PACE DRAP
3.6. RI-AIAC
4. Comparisons
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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INFECTIVE RISK SCORE | RISK FACTORS | POINTS | SCORE | INFECTION RISK | ||||
---|---|---|---|---|---|---|---|---|
PADIT | Age | <60 years | 2 | 0–4 | Low (<1%) | |||
60–69 years | 1 | |||||||
Renal insufficiency (eGFR <30 mL/min) | 1 | |||||||
Immunocompromised * | 3 | 5–6 | Intermediate (1–3%) | |||||
Procedure type | ICD | 2 | ||||||
CRT | 4 | |||||||
Revision/Upgrade | 5 | ≥7 | High (>3%) | |||||
Number of previous procedures | 1 | 1 | ||||||
≥2 | 4 | |||||||
SHARIFF | Diabetes | 1 | <3 | Low (1%) | ||||
Heart failure | 1 | |||||||
Oral anticoagulation | 1 | |||||||
Chronic corticosteroid use | 1 | |||||||
Renal insufficiency (Cr > 1.5 mg/dL) | 1 | |||||||
Prior CIED infection | 1 | ≥3 | High (2.4%) | |||||
>2 leads | 1 | |||||||
Epicardial lead(s) | 1 | |||||||
Temporary pacing | 1 | |||||||
Generator replacement or upgrade | 1 | |||||||
KOLEK | Diabetes | 1 | <2 | Low | ||||
Renal insufficiency (Cr ≥1.5 mg/dL) | 1 | |||||||
Systemic anticoagulation | 1 | |||||||
Chronic corticosteroid use | 1 | |||||||
Preimplant fever ⁺ or leukocytosis † | 1 | |||||||
Prior CIED infection | 1 | ≥2 | High (1.9–2.2%) | |||||
≥3 transvenous leads | 1 | |||||||
Pacemaker dependence | 1 | |||||||
Early pocket reentry (within 2 weeks of implantation) | 1 | |||||||
MITTAL | Early pocket reintervention | 11 | 0–7 | Low (1%) | ||||
Male sex | 6 | |||||||
Diabetes | 3 | 8–14 | Intermediate (3.4%) | |||||
Upgrade | 2 | |||||||
Heart failure | 1 | |||||||
Hypertension | 1 | ≥15 | High (11.1%) | |||||
Renal dysfunction (eGFR < 60 mL/min) | 1 | |||||||
PACE DRAP | Valvular prosthesis | 2 | <6 | Low (0.7%) | ||||
Hypertension (≥160/100 mmHg) | 2 | |||||||
Cancer (within last 5 years) | 2 | |||||||
Age ≥ 75 years | 2 | |||||||
CRT/ICD surgery | 2 | |||||||
Upgrade | 2 | ≥6 | High (4.6%) | |||||
Antiplatelets | Clopidogrel | 2 | ||||||
Ticagrelor | 3 | |||||||
Renal disfunction (eGFR < 60 mL/min) | 1 | |||||||
RI AIAC | Revision/Upgrading/Reimplantation | 2 | 0 | Low | ||||
CIED replacement | 1 | |||||||
Diabetes | 1 | ≥1 | High | |||||
Hospital-acquired infection | 1 |
PADIT | SHARIFF | KOLEK | MITTAL | PACE DRAP | RI AIAC | |
---|---|---|---|---|---|---|
Reference | [25] | [19] | [30] | [32] | [34] | [27] |
Design | Prospective, multicenter, cluster-randomized | Retrospective, single-center | Prospective, single-center | Retrospective, single-center | Prospective, single-center | Prospective, multicenter |
Patients | 19,603 | 1476 | 899 | 2891 | 1000 | 2675 |
Follow-up | 1 year | 6 months | 18.7 ± 7.7 and 42.4 ± 5.2 months | 6 months | 1 year | 1 year |
Infection rate | 0.9% | 1.29% | 2.22% | 1.14% | 1.8% | 1.1% |
External validation | Yes [28] | Yes [29] | Yes [31] | No | No | Yes [27] |
Patients in external validation cohort | 51623 | 1391 | 1124 | // | // | 1017 |
AUC in PACE DRAP study comparison [34] | 0.63 | // | // | // | 0.72 | // |
C-index (95% CI) in RI-AIAC study comparison [27] | 0.53 (0.38–0.67) | 0.62 (0.46–0.77) | 0.64 (0.5–0.79) | // | // | 0.58 (0.42–0.74) |
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Malagù, M.; Donazzan, L.; Capanni, A.; Sirugo, P.; Rapezzi, C.; Bertini, M. Risk Scores for Cardiac Implantable Electronic Device Infection: Which One to Believe In? J. Clin. Med. 2022, 11, 6556. https://doi.org/10.3390/jcm11216556
Malagù M, Donazzan L, Capanni A, Sirugo P, Rapezzi C, Bertini M. Risk Scores for Cardiac Implantable Electronic Device Infection: Which One to Believe In? Journal of Clinical Medicine. 2022; 11(21):6556. https://doi.org/10.3390/jcm11216556
Chicago/Turabian StyleMalagù, Michele, Luca Donazzan, Andrea Capanni, Paolo Sirugo, Claudio Rapezzi, and Matteo Bertini. 2022. "Risk Scores for Cardiac Implantable Electronic Device Infection: Which One to Believe In?" Journal of Clinical Medicine 11, no. 21: 6556. https://doi.org/10.3390/jcm11216556
APA StyleMalagù, M., Donazzan, L., Capanni, A., Sirugo, P., Rapezzi, C., & Bertini, M. (2022). Risk Scores for Cardiac Implantable Electronic Device Infection: Which One to Believe In? Journal of Clinical Medicine, 11(21), 6556. https://doi.org/10.3390/jcm11216556