Predictors of infection after “de novo” cardiac electronic device implantation

Background Cardiac implantable electronic device (CIED) infection is a major complication that increases morbidity and mortality after the procedure. Several infection risk scores have been suggested to identify patients at higher pre-procedural risk of infection Objective this study sought to evaluate rates of infection, potential risk factors and the role of a modified "Shariff" score as predictor of infection in high-risk patients undergoing de novo CIED implantation. Methods and Results We retrospectively analysed 1391 patients underwent a de novo CIED procedure during the study period. At the median follow-up of 48 months, 20 patients of 1391 (1.4%) developed a CIED-related infective event. In our population, we studied a modified version of the "Shariff" score for only first-time implant patients. At multivariate regression analysis, three factors were independent predictors of infection: previous pocket hematoma [RR 27.2 (8.30–54.02), p = 10−10], a Shariff Score ≥ 4 [RR 3.20 (1.29–12.59), p= 0.029]. and reintervention for catheter malfunction or dislocation [RR 3.57 (1.2–37.4), p= 0.048]. Conclusions a "Shariff" score > 4 is suggested as a predictor of higher risk of infection in patients after de novo device implantation. The use of an infection risk score may help to improve tailored pre-operatory strategies to prevent infection.