非常难得的一项有关起搏器感染率和危险因素的大样本队列研究
Eur Heart J. 2011 Apr;32(8):991-8. Epub 2011 Jan 20.Infection after pacemaker implantation: infection rates and risk factors associated with infection in a population-based cohort study of 46299 consecutive patients.
Johansen JB, Jørgensen OD, Møller M, Arnsbo P, Mortensen PT, Nielsen JC.
Source
Danish Pacemaker Register, Department of Cardiology, Odense University Hospital, DK 5000 Odense C, Denmark. brock@dadlnet.dk
Abstract
AIMS:
Infection is a serious complication of pacemaker (PM) systems. Although the rate of infection has been debated, the figures are largely unknown. We therefore studied the incidence of PM infection and its associated risk factors in the Danish population.
METHODS AND RESULTS:
Since 1982, all PM implantation and removal procedures performed in Denmark have been prospectively recorded in the Danish Pacemaker Register. All patients (n = 46299) who underwent implantation between 1982 and 2007 were included. The total length of surveillance was 236,888 PM-years. The incidence of infection was calculated according to the total number of PM-years. The incidence of surgical site infection (≤ 365 days after PM implantation) was compared with later infection in first implant and replacement procedures. Multiple-record and multiple-event-per-subject proportional hazards analyses were used to identify the independent risk factors of PM infection. Surgical site infection occurred in 192 cases after first implantation (incidence rate 4.82/1000 PM-years), and in 133 cases after replacement (12.12/1000 PM-years). Infections occurring more than 365 days after the first implantation occurred in 153 cases (1.02/1000 PM-years), and in 118 cases after replacement (3.26/1000 PM-years). Independent factors associated with an increased risk of PM infection were a greater number of PM operations (including replacements), male sex, younger age, implantation during the earliest part of the study period, and absence of antibiotics (P< 0.001).
CONCLUSION:
The overall risk of infection after PM implantation was low. A greater number of operations augmented the risk of infection. This should be taken into account when considering revisions of PM systems.
有免费全文，所以在此不上传
确实非常难得，从1982年开始的研究，佩服佩服！ 全英文！惭愧！让科室的好同事学习，因为很想知道有关起搏器的。感谢老师！ 目标
感染时起搏器系统的严重并发症。尽管感染率一直被讨论，然而很大程度上这些数据并不为人所知。因此我们在丹麦人群中研究PM感染的发生率和与其相关的风险因素。
方法与结果：
自1982年，所有在丹麦进行的植入和取出PM的操作均在丹麦起搏器中心前瞻性登记。在1982年至2007年共计46299例病人安装起搏器。全部监测时间236888起搏器-年。感染发生率按照起搏器-年进行计算。对比第一次安装和重复安装手术部位感染发生（安装起搏器后不足365天）情况。多项纪录和多种事件/个体比风险分析用于发现独立的PM感染风险。在第一次安装起搏器的病人有192例感染（感染率4.82/1000PM年），而重置起搏器的病人有133例感染（12.12/1000PM-年）第一次安装起搏器患者感染发生在365天之后的有153例（感染率1.02/1000PM-年），在重置起搏器者有118例（3.26/1000PM-年）。PM感染增加风险相关独立因素是PM操作的次数（包括重置），男性，低龄，在研究最早期进行的放置操和未使用抗菌素（p<0.001）.
结论：
在PM安置的整体感染风险较低。大量的手术增加了感染的风险，PM系统修订时应当考虑到这些因素。
gemao 发表于 2012-9-17 09:45 static/image/common/back.gif
目标
感染时起搏器系统的严重并发症。尽管感染率一直被讨论，然而很大程度上这些数据并不为人所知。因此我 ...
这是一带空白地带，国内很缺乏这方面的资料
页:
[1]