Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
JAMA. 2012 Apr 25;307(16):1727-35. doi: 10.1001/jama.2012.497.

Clinical characteristics and outcome of infective endocarditis involving implantable cardiac devices.

Collaborators (316)

Clara L, Sanchez M, Nacinovich F, Fernandez Oses P, Ronderos R, Sucari A, Thierer J, Casabé J, Cortes C, Altclas J, Kogan S, Spelman D, Athan E, Harris O, Kennedy K, Tan R, Gordon D, Papanicolas L, Eisen D, Grigg L, Street A, Korman T, Kotsanas D, Dever R, Jones P, Konecny P, Lawrence R, Rees D, Ryan S, Feneley MP, Harkness J, Jones P, Ryan S, Jones P, Ryan S, Jones P, Post J, Reinbott P, Ryan S, Gattringer R, Wiesbauer F, Andrade AR, de Brito AC, Guimarães AC, Grinberg M, Mansur AJ, Siciliano RF, Strabelli TM, Vieira ML, Tranchesi RA, Paiva MG, Fortes CQ, Ramos Ade O, Ferraiuoli G, Golebiovski W, Lamas C, Santos M, Weksler C, Karlowsky JA, Keynan Y, Morris AM, Rubinstein E, Braun Jones S, Garcia P, Cereceda M, Fica A, Montagna Mella R, Barsic B, Bukovski S, Krajinovic V, Pangercic A, Rudez I, Vincelj J, Freiberger T, Pol J, Zaloudikova B, Ashour Z, El Kholy A, Mishaal M, Rizk H, Aissa N, Alauzet C, Alla F, Campagnac C, Doco-Lecompte T, Selton-Suty C, Casalta JP, Fournier PE, Habib G, Raoult D, Thuny F, Delahaye F, Delahaye A, Vandenesch F, Donal E, Donnio PY, Michelet C, Revest M, Tattevin P, Violette J, Chevalier F, Jeu A, Rusinaru D, Sorel C, Tribouilloy C, Bernard Y, Chirouze C, Hoen B, Leroy J, Plesiat P, Mazaheri B, Naber C, Neuerburg C, Athanasia S, Giannitsioti E, Mylona E, Paniara O, Papanicolaou K, Pyros J, Skoutelis A, Sharma G, Francis J, Nair L, Thomas V, Venugopal K, Hannan M, Hurley J, Gilon D, Israel S, Korem M, Rubinstein E, Strahilevitz J, Casillo R, Cuccurullo S, Dialetto G, Durante-Mangoni E, Irene M, Ragone E, Tripodi MF, Utili R, Cecchi E, De Rosa F, Forno D, Imazio M, Trinchero R, Tebini A, Grossi P, Lattanzio M, Toniolo A, Goglio A, Raglio A, Ravasio V, Rizzi M, Suter F, Carosi G, Magri S, Signorini L, Baban T, Kanafani Z, Kanj SS, Yasmine M, Abidin I, Tamin SS, Rivera Martínez E, Soto Nieto GI, van der Meer JT, Chambers S, Holland D, Morris A, Raymond N, Read K, Murdoch DR, Dragulescu S, Ionac A, Mornos C, Butkevich O, Chipigina N, Kirill O, Vadim K, Vinogradova T, Edathodu J, Halim M, Lum LN, Tan RS, Lejko-Zupanc T, Logar M, Mueller-Premru M, Commerford P, Commerford A, Deetlefs E, Hansa C, Ntsekhe M, Almela M, Armero Y, Azqueta M, Castañeda X, Cervera C, del Río A, Falces C, Garcia-de-la-Maria C, Fita G, Gatell JM, Marco F, Mestres CA, Miró JM, Moreno A, Ninot S, Paré C, Pericas J, Ramírez J, Rovira I, Sitges M, Anguera I, Font B, Raimon Guma J, Bermejo J, Bouza E, García Fernández MA, González-Ramallo V, Marín M, Muñoz P, Pedromingo M, Roda J, Rodríguez-Créixems M, Solís J, Almirante B, Fernández-Hidalgo N, Tornos P, de Alarcón A, Parra R, Alestig E, Johansson M, Olaison L, Snygg-Martin U, Pachirat O, Pachirat P, Pussadhamma B, Senthong V, Casey A, Elliott T, Lambert P, Watkin R, Eyton C, Klein JL, Bradley S, Kauffman C, Bedimo R, Chu VH, Corey G, Crowley AL, Douglas P, Drew L, Fowler VG, Holland T, Lalani T, Mudrick D, Samad Z, Sexton D, Stryjewski M, Wang A, Woods CW, Lerakis S, Cantey R, Steed L, Wray D, Dickerman SA, Bonilla H, DiPersio J, Salstrom SJ, Baddley J, Patel M, Peterson G, Stancoven A, Afonso L, Kulman T, Levine D, Rybak M, Cabell CH, Baloch K, Chu VH, Corey G, Dixon CC, Fowler VG Jr, Harding T, Jones-Richmond M, Pappas P, Park LP, Redick T, Stafford J, Anstrom K, Athan E, Bayer AS, Cabell CH, Chu VH, Corey G, Fowler VG Jr, Hoen B, Karchmer A, Miró JM, Murdoch DR, Sexton DJ, Wang A, Bayer AS, Cabell CH, Chu V, Corey G, Durack DT, Eykyn S, Fowler VG Jr, Hoen B, Miró JM, Moreillon P, Olaison L, Raoult D, Rubinstein E, Sexton DJ.

Author information

  • 1Department of Infectious Diseases, Barwon Health, Geelong, Australia.

Abstract

CONTEXT:

Infection of implantable cardiac devices is an emerging disease with significant morbidity, mortality, and health care costs.

OBJECTIVES:

To describe the clinical characteristics and outcome of cardiac device infective endocarditis (CDIE) with attention to its health care association and to evaluate the association between device removal during index hospitalization and outcome.

DESIGN, SETTING, AND PATIENTS:

Prospective cohort study using data from the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), conducted June 2000 through August 2006 in 61 centers in 28 countries. Patients were hospitalized adults with definite endocarditis as defined by modified Duke endocarditis criteria.

MAIN OUTCOME MEASURES:

In-hospital and 1-year mortality.

RESULTS:

CDIE was diagnosed in 177 (6.4% [95% CI, 5.5%-7.4%]) of a total cohort of 2760 patients with definite infective endocarditis. The clinical profile of CDIE included advanced patient age (median, 71.2 years [interquartile range, 59.8-77.6]); causation by staphylococci (62 [35.0% {95% CI, 28.0%-42.5%}] Staphylococcus aureus and 56 [31.6% {95% CI, 24.9%-39.0%}] coagulase-negative staphylococci); and a high prevalence of health care-associated infection (81 [45.8% {95% CI, 38.3%-53.4%}]). There was coexisting valve involvement in 66 (37.3% [95% CI, 30.2%-44.9%]) patients, predominantly tricuspid valve infection (43/177 [24.3%]), with associated higher mortality. In-hospital and 1-year mortality rates were 14.7% (26/177 [95% CI, 9.8%-20.8%]) and 23.2% (41/177 [95% CI, 17.2%-30.1%]), respectively. Proportional hazards regression analysis showed a survival benefit at 1 year for device removal during the initial hospitalization (28/141 patients [19.9%] who underwent device removal during the index hospitalization had died at 1 year, vs 13/34 [38.2%] who did not undergo device removal; hazard ratio, 0.42 [95% CI, 0.22-0.82]).

CONCLUSIONS:

Among patients with CDIE, the rate of concomitant valve infection is high, as is mortality, particularly if there is valve involvement. Early device removal is associated with improved survival at 1 year.

Comment in

PMID:
22535857
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems
    Loading ...
    Write to the Help Desk