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Epidemiology of infection in mechanical circulatory support: A global analysis from the ISHLT Mechanically Assisted Circulatory Support Registry
- Source :
- The Journal of Heart and Lung Transplantation. 38:364-373
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- BACKGROUND Despite advances in device technology and treatment strategies, infection remains a major cause of adverse events (AEs) in mechanical circulatory support (MCS) patients. To characterize the epidemiology of MCS infection, we examined the type, location, and timing of infection in the International Society for Heart and Lung Transplantation Registry (ISHLT) for Mechanically Assisted Circulatory Support (IMACS) over 3 years, 2013 to 2015. METHODS Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) definitions were used to categorize AE infections occurring in MCS patients within IMACS. The IMACS infection variables were mapped to ISHLT definitions for infection where feasible. Three categories of MCS infection were defined as ventricular assist device (VAD) specific, VAD related, and non-VAD. RESULTS There were 10,171 patients enrolled from January 2013 through December 2015. Infection was the most common AE, with 3,788 patients (37%) experiencing ≥ 1 infection, and 6,758 AE infections reported overall. Non-VAD infection was the largest category, 4,501: 34.0% pneumonias, 30.6% non-VAD-related bloodstream infections (BSIs), 24.15% urinary tract infections (UTIs), and 10.2% gastrointestinal infections. VAD-specific infection was the second largest category, 1,756: 82.9% driveline, 12.8% pocket, and 4.3% pump/or cannula infections. VAD-related infection was the smallest category, 501: 47.5% BSIs, 47.5% mediastinitis, and 5.0% mediastinitis/pocket infections. All 3 categories were more frequently reported ≤ 3 months after implant. CONCLUSIONS Non-VAD infection, including pneumonia, BSI, UTI, and gastrointestinal infection, was the leading category of infection in MCS patients and the most frequently reported ≤ 3 months after implant. These results provide evidence to support resourcing and strengthening infection prevention strategy early after implantation in MCS.
- Subjects :
- Adult
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Prosthesis-Related Infections
Heart-Lung Transplantation
International Cooperation
medicine.medical_treatment
Urinary system
030204 cardiovascular system & hematology
Young Adult
03 medical and health sciences
0302 clinical medicine
Internal medicine
Epidemiology
medicine
Humans
Lung transplantation
Infection control
Registries
030212 general & internal medicine
Adverse effect
Societies, Medical
Aged
Heart Failure
Transplantation
business.industry
Middle Aged
medicine.disease
Mediastinitis
Pneumonia
Ventricular assist device
Female
Surgery
Heart-Assist Devices
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 10532498
- Volume :
- 38
- Database :
- OpenAIRE
- Journal :
- The Journal of Heart and Lung Transplantation
- Accession number :
- edsair.doi.dedup.....2abc4f4be3363f978350bb4c83c93f49
- Full Text :
- https://doi.org/10.1016/j.healun.2019.01.007