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Clinical and financial outcomes of hospitalizations for cardiac device infection during the COVID-19 pandemic in the US
BACKGROUND: Cardiac device infection (CDI) can occur in up to 2.2% of patients after device placement, with mortality rates exceeding 15%. Although device removal is standard management, the COVID-19 pandemic has been associated with resource diversion and decreased patient presentation for cardiova...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10511080/ https://www.ncbi.nlm.nih.gov/pubmed/37729193 http://dx.doi.org/10.1371/journal.pone.0291774 |
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author | Ascandar, Nameer Chervu, Nikhil Bakhtiyar, Syed Shahyan Cho, Nam Yong Kim, Shineui Orellana, Manuel Benharash, Peyman |
author_facet | Ascandar, Nameer Chervu, Nikhil Bakhtiyar, Syed Shahyan Cho, Nam Yong Kim, Shineui Orellana, Manuel Benharash, Peyman |
author_sort | Ascandar, Nameer |
collection | PubMed |
description | BACKGROUND: Cardiac device infection (CDI) can occur in up to 2.2% of patients after device placement, with mortality rates exceeding 15%. Although device removal is standard management, the COVID-19 pandemic has been associated with resource diversion and decreased patient presentation for cardiovascular disease. We ascertained the association of the COVID-19 pandemic with outcomes and resource utilization after admission for CDI. METHODS: The 2016–2020 National Inpatient Sample was used to retrospectively study all adult admissions for CDI. Patients admitted between March and December, 2020 were classified as the pandemic cohort, with the rest pre-pandemic. The primary outcome was major adverse events (MAE), with secondary outcomes of overall length of stay (LOS), post-device removal LOS, time to device replacement, and hospitalization costs. MAE was a combination of in-hospital mortality and select complications. Multivariable regression models were developed to determine the relationship between the pandemic and the aforementioned outcomes. RESULTS: Of an estimated 190,160 patients, 14.3% comprised the pandemic cohort; 2.4% of these patients were COVID-19 positive. The pandemic cohort was older, less commonly female, and had higher rates of congestive heart failure. After adjustment, the pandemic was not associated with altered odds of MAE, device removal, or subsequent device replacement. The pandemic was, however, associated with decreased adjusted overall LOS (β -0.38 days) and days to device replacement (β -0.83 days). The pandemic was likewise associated with $2,000 increased adjusted hospitalization costs. CONCLUSION: The pandemic did not have a significant impact on clinical outcomes in patients admitted for CDI, despite higher hospitalization costs and decreased length of stay. |
format | Online Article Text |
id | pubmed-10511080 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-105110802023-09-21 Clinical and financial outcomes of hospitalizations for cardiac device infection during the COVID-19 pandemic in the US Ascandar, Nameer Chervu, Nikhil Bakhtiyar, Syed Shahyan Cho, Nam Yong Kim, Shineui Orellana, Manuel Benharash, Peyman PLoS One Research Article BACKGROUND: Cardiac device infection (CDI) can occur in up to 2.2% of patients after device placement, with mortality rates exceeding 15%. Although device removal is standard management, the COVID-19 pandemic has been associated with resource diversion and decreased patient presentation for cardiovascular disease. We ascertained the association of the COVID-19 pandemic with outcomes and resource utilization after admission for CDI. METHODS: The 2016–2020 National Inpatient Sample was used to retrospectively study all adult admissions for CDI. Patients admitted between March and December, 2020 were classified as the pandemic cohort, with the rest pre-pandemic. The primary outcome was major adverse events (MAE), with secondary outcomes of overall length of stay (LOS), post-device removal LOS, time to device replacement, and hospitalization costs. MAE was a combination of in-hospital mortality and select complications. Multivariable regression models were developed to determine the relationship between the pandemic and the aforementioned outcomes. RESULTS: Of an estimated 190,160 patients, 14.3% comprised the pandemic cohort; 2.4% of these patients were COVID-19 positive. The pandemic cohort was older, less commonly female, and had higher rates of congestive heart failure. After adjustment, the pandemic was not associated with altered odds of MAE, device removal, or subsequent device replacement. The pandemic was, however, associated with decreased adjusted overall LOS (β -0.38 days) and days to device replacement (β -0.83 days). The pandemic was likewise associated with $2,000 increased adjusted hospitalization costs. CONCLUSION: The pandemic did not have a significant impact on clinical outcomes in patients admitted for CDI, despite higher hospitalization costs and decreased length of stay. Public Library of Science 2023-09-20 /pmc/articles/PMC10511080/ /pubmed/37729193 http://dx.doi.org/10.1371/journal.pone.0291774 Text en © 2023 Ascandar et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Ascandar, Nameer Chervu, Nikhil Bakhtiyar, Syed Shahyan Cho, Nam Yong Kim, Shineui Orellana, Manuel Benharash, Peyman Clinical and financial outcomes of hospitalizations for cardiac device infection during the COVID-19 pandemic in the US |
title | Clinical and financial outcomes of hospitalizations for cardiac device infection during the COVID-19 pandemic in the US |
title_full | Clinical and financial outcomes of hospitalizations for cardiac device infection during the COVID-19 pandemic in the US |
title_fullStr | Clinical and financial outcomes of hospitalizations for cardiac device infection during the COVID-19 pandemic in the US |
title_full_unstemmed | Clinical and financial outcomes of hospitalizations for cardiac device infection during the COVID-19 pandemic in the US |
title_short | Clinical and financial outcomes of hospitalizations for cardiac device infection during the COVID-19 pandemic in the US |
title_sort | clinical and financial outcomes of hospitalizations for cardiac device infection during the covid-19 pandemic in the us |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10511080/ https://www.ncbi.nlm.nih.gov/pubmed/37729193 http://dx.doi.org/10.1371/journal.pone.0291774 |
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