{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T22:48:53Z","timestamp":1794264533548,"version":"4.9.0"},"reference-count":29,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"<jats:sec id=\"ab-hoi230011-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Cardiac implantable electronic device (CIED) infection is a potentially devastating complication with an estimated 12-month mortality of 15% to 30%. The association of the extent (localized or systemic) and timing of infection with all-cause mortality has not been established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi230011-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association of the extent and timing of CIED infection with all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi230011-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This prospective observational cohort study was conducted between December 1, 2012, and September 30, 2016, in 28 centers across Canada and the Netherlands. The study included 19\u202f559 patients undergoing CIED procedures, 177 of whom developed an infection. Data were analyzed from April 5, 2021, to January 14, 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi230011-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Prospectively identified CIED infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi230011-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Time-dependent analysis of the timing (early [\u22643 months] or delayed [3-12 months]) and extent (localized or systemic) of infection was performed to determine the risk of all-cause mortality associated with CIED infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi230011-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 19\u202f559 patients undergoing CIED procedures, 177 developed a CIED infection. The mean (SD) age was 68.7 (12.7) years, and 132 patients were male (74.6%). The cumulative incidence of infection was 0.6%, 0.7%, and 0.9% within 3, 6, and 12 months, respectively. Infection rates were highest in the first 3 months (0.21% per month), reducing significantly thereafter. Compared with patients who did not develop CIED infection, those with early localized infections were not at higher risk for all-cause mortality (no deaths at 30 days [0 of 74 patients]: adjusted hazard ratio [aHR], 0.64 [95% CI, 0.20-1.98];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.43). However, patients with early systemic and delayed localized infections had an approximately 3-fold increase in mortality (8.9% 30-day mortality [4 of 45 patients]: aHR, 2.88 [95% CI, 1.48-5.61];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.002; 8.8% 30-day mortality [3 of 34 patients]: aHR, 3.57 [95% CI, 1.33-9.57];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.01), increasing to a 9.3-fold risk of death for those with delayed systemic infections (21.7% 30-day mortality [5 of 23 patients]: aHR, 9.30 [95% CI, 3.82-22.65];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi230011-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Findings suggest that CIED infections are most common within 3 months after the procedure. Early systemic infections and delayed localized infections are associated with increased mortality, with the highest risk for patients with delayed systemic infections. Early detection and treatment of CIED infections may be important in reducing mortality associated with this complication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamacardio.2023.0467","type":"journal-article","created":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T11:02:30Z","timestamp":1680692550000},"page":"484","source":"Crossref","is-referenced-by-count":20,"title":["Association of the Timing and Extent of Cardiac Implantable Electronic Device Infections With Mortality"],"prefix":"10.1001","volume":"8","author":[{"given":"Hui-Chen","family":"Han","sequence":"first","affiliation":[{"name":"Centre for Cardiovascular Innovation, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Victorian Heart Institute, Monash University, Clayton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Wang","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H.","family":"Birnie","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Alings","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Amphia Ziekenhuis & Working Group on Cardiovascular Research the Netherlands (WCN), Breda, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Philippon","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec, Laval University, Quebec City, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratika","family":"Parkash","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Queen Elizabeth II Health Sciences Center, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaimie","family":"Manlucu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Lawson Health Research Institute, London Health Sciences, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Angaran","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Toronto, St Michael Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Rinne","sequence":"additional","affiliation":[{"name":"Division of Cardiology, St Mary\u2019s General Hospital, Kitchener, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Coutu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CHUM), University of Montreal, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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