所属 医学部 医学科（東京女子医科大学病院） 職種 特任准教授
|発表タイトル||Predictors of 1-year Mortality among Japanese Patients with Infected Cardiac Implantable Electrical Device Undergoing Lead Extraction|
|発表者・共同発表者||◎逸見隆太, 庄田守男, 江島浩一郎, 柳下大悟, 岩波裕史, 萩原誠久|
|学会抄録||第81回日本循環器学会学術集会 プログラム集 234|
|概要||Introduction: Infection of cardiac implantable electrical devices (CIED) is a disease with serious morbidity and mortality. Although previous studies showed that 1‒year mortality was between 10% and 20%, little is known about the mortality after lead extraction among Japanese patients with CIED infection. We aimed to evaluate the long‒term outcomes of lead extractions.
Methods: We retrospectively reviewed 105 consecutive patients with CIED infection who underwent lead extraction from January 2012 to March 2016.
Results: The patient characteristics are as follows: mean age 64±18 years, male in 77%, systemic infection in 25%, renal dialysis in 2.8%, and low‒voltage device in 58%. Extraction was successful in 99% of patients with complete or partial removal of the infected leads. Surgical removal was performed in 9.5% (n=10). Thirty‒day mortality was 1.0% (n=1). One‒year mortality was 4.0% (n=4). Using Cox regression univariable model, systemic infection (hazard ratio 9.18; P=0.034) and renal dialysis (hazard ratio 88.4; P<0.001) were significant predictors of 1‒year mortality. Systemic infection was associated with higher 30‒day (3.9%) and 1‒year (12%) mortality rates and renal dialysis was with higher 30‒day (33%) and 1‒year (67%) mortality rates.
Conclusions: Our first domestic investigation regarding prognosis after extraction of infected leads demonstrated that systemic infection and renal dialysis were associated with higher mortality, and the post‒procedural mortality was lower than in the previously reported studies.