Academic Journal
Lead Extraction and Outcomes in Frail Patients With Cardiac Implantable Electronic Device Infections in the United States.
| Τίτλος: | Lead Extraction and Outcomes in Frail Patients With Cardiac Implantable Electronic Device Infections in the United States. |
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| Συγγραφείς: | Bharadiya V; Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA., Agarwal S; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA., Analuisa KQ; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA., Patil SP; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA., Mainigi N; University of Pennsylvania, Philadelphia, Pennsylvania, USA., Asad ZUA; Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA., Munir MB; Division of Cardiovascular Medicine, University of California Davis, Sacramento, California, USA., DeSimone DC; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.; Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA., DeSimone CV; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA., Deshmukh AJ; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA. |
| Πηγή: | Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2026 Jul; Vol. 37 (7), pp. 1588-1591. Date of Electronic Publication: 2026 Apr 27. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Blackwell Country of Publication: United States NLM ID: 9010756 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8167 (Electronic) Linking ISSN: 10453873 NLM ISO Abbreviation: J Cardiovasc Electrophysiol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Malden, MA : Blackwell Original Publication: Mt. Kisco, N.Y. : Futura Pub., c1990- |
| Ιατρικοί όροι (MeSH): | Device Lead Extraction*/adverse effects , Device Lead Extraction*/mortality , Defibrillators, Implantable*/adverse effects , Device Removal*/mortality , Device Removal*/adverse effects , Pacemaker, Artificial*/adverse effects , Prosthesis-Related Infections*/mortality , Prosthesis-Related Infections*/diagnosis , Prosthesis-Related Infections*/surgery , Prosthesis-Related Infections*/therapy , Prosthesis-Related Infections*/microbiology , Frailty*/mortality , Frailty*/diagnosis , Frailty*/epidemiology , Frail Elderly*, United States/epidemiology ; Humans ; Female ; Male ; Aged ; Risk Factors ; Treatment Outcome ; Hospital Mortality ; Time Factors ; Databases, Factual ; Prevalence ; Middle Aged ; Risk Assessment ; Patient Readmission ; Aged, 80 and over ; Retrospective Studies |
| Περίληψη: | Introduction: Frailty is increasingly recognized as an important determinant of outcomes in cardiovascular disease, yet its population-level impact among patients hospitalized with cardiac implantable electronic device (CIED) infections remains incompletely defined. We examined the prevalence of frailty and its association with clinical outcomes and utilization of transvenous lead removal (TLR) in a contemporary national cohort. Methods and Results: We analyzed the National Readmissions Database from 2016-2021 to identify adults hospitalized for CIED infections. Frailty was defined using the Johns Hopkins adjusted clinical groups frailty-defining diagnoses. Of 288,402 patients hospitalized with CIED infections, 25.1% were classified as frail. Frail patients experienced significantly higher in-hospital mortality (10.8% vs. 4.6%), 30-day mortality (9.2% vs. 5.5%), complications, longer length of stay, lower rates of discharge home, and higher 30-day readmissions compared with non-frail patients (all p < 0.01). TLR was performed less frequently in frail patients (10.8% vs. 13.4%; adjusted odds ratio [aOR] 0.80, 95% CI 0.76-0.83). On adjusted analyses, TLR was independently associated with lower in-hospital mortality, 30-day mortality, and 30-day readmissions in both frail and non-frail patients. Conclusion: Among patients hospitalized with CIED infections, TLR was independently associated with lower mortality and readmissions in both frail and non-frail patients, despite lower utilization in frail individuals. Frailty was common (25.1%) and independently associated with significantly worse outcomes. These findings highlight important associations between frailty, treatment patterns, and outcomes that warrant prospective evaluation. (© 2026 Wiley Periodicals LLC.) |
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| Contributed Indexing: | Keywords: cardiac implantable electronic device; frailty; mortality; outcomes; transvenous lead extraction |
| Entry Date(s): | Date Created: 20260427 Date Completed: 20260716 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13372417 |
| DOI: | 10.1111/jce.70347 |
| PMID: | 42037139 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1540-8167 |
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| DOI: | 10.1111/jce.70347 |