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• W4377014622 abstract "Cardiac implantable electronic device (CIED)-associated infections lead to substantial morbidity, mortality and healthcare costs. Despite guideline recommendations for complete CIED system removal for patients with infective endocarditis, utilization of transvenous lead extraction (TLE) is often delayed or not performed in clinical practice. The impact of hospital TLE volume on practice patterns has not been evaluated. To examine impact of hospital TLE procedural volume on utilization of TLE and clinical outcomes for patients with CIEDs hospitalized with infective endocarditis (IE). Using the Nationwide Readmissions Database (NRD), we evaluated 21,545 admissions for patients (mean age 70.3, 38.6% female) with prior CIED hospitalized with IE. Only admissions to TLE-performing centers were included in the analysis. Hospitals were categorized into three groups based on total annual TLE volume tertiles: 1) low volume TLE centers (<18 TLE procedures/year) 2) medium volume TLE centers (18-45 TLEs/year) and 3) high volume TLE centers (>45 TLEs/year). Among study patients with CIEDs and IE, TLE was performed during 6.9%, 19.3% and 26% of admissions in low, medium and high volume TLE centers, respectively (P < 0.001). Hospitalization for IE at a high TLE center was independently associated with increased odds of management with lead extraction when compared to low volume TLE centers (aOR 4.26; 95% CI 3.53 – 5.15). Among patients with Staphylococcus aureus infections, TLE was performed in 16.4%, 36.6% and 41.4% of admissions to low, medium and high TLE centers, respectively (P < 0.001). Lead extraction-associated complication rates were similar at 2.5%, 2.3% and 3.4% at low, medium and high TLE centers, respectively (P = 0.493). Overall inpatient mortality for all admissions with IE to low, medium and high volume centers was similar at 9.2%, 9.6% and 9.6%, respectively (P = 0.804). Transvenous lead extraction is under-utilized in the management of CIED-associated infective endocarditis. Presentation to high volume TLE centers is associated with higher utilization of transvenous lead extraction." @default.
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• W4377014622 date "2023-05-01" @default.
• W4377014622 modified "2023-09-26" @default.
• W4377014622 title "PO-02-050 IMPACT OF HOSPITAL LEAD EXTRACTION PROCEDURAL VOLUME ON MANAGEMENT OF PATIENTS WITH CARDIAC IMPLANTABLE ELECTRONIC DEVICES HOSPITALIZED WITH INFECTIVE ENDOCARDITIS" @default.
• W4377014622 doi "https://doi.org/10.1016/j.hrthm.2023.03.843" @default.
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