Surgical infections associated with pacemakers and defibrillators led to 3-fold increases in hospital stay, 55 percent to 118 percent higher hospitalization costs, eight- to 11-fold increase in mortality rates, and double the mortality after one year compared to pacemaker and defibrillator implantations where no infection occurred. Surprisingly, more than one-third of the excess mortality occurred after hospital discharge. These findings, from a new study in Medicare beneficiaries of more than 200,000 pacemaker and defibrillator implantations with and without infection, were presented today at a poster session at the American College of Cardiology 60th Annual Scientific Session by researchers from the Mayo Clinic, The Johns Hopkins School of Medicine, and TYRX, Inc.
"Rising healthcare costs are at the center of the political and economic debate this year," says M. Rizwan Sohail, MD, assistant professor of medicine ay the Mayo Clinic College of Medicine in Rochester, Minn., lead author of the new study. "However, efforts at cost reduction must begin by identifying the major driving forces behind the cost of patient care. In this study, we have tried to do just that for patients with cardiac device infections."
Key findings from the study included:
- The in-hospital mortality rate for pacemaker and defibrillator implantation admissions, with an infection, was 8- to 11-fold the rate for non-infected admissions, depending on the device type.
- The longer-term mortality rate (death during the admission quarter and following year) was 27-36%, about 2-fold the rate without infection, depending on the device type.
- The mean hospital length of stay (LOS) with infection was three-fold the length of stay without infection. Moreover it was substantially longer than the mean LOS for Medicare beneficiary admissions for the five leading principal diagnostic classifications: heart disease, pneumonia, malignant neoplasm, cerebrovascular disease, and fractures at all sites.
Mean total hospitalization cost for pacemaker and defibrillator patients with infection was 55 percent to 118 percent higher than for those without infection, depending on the type of device. The incremental costs related to the treatment of the infection ranged from an average of $17,000 for pacemaker infections to $25,600 for certain types of defibrillators. The Medicare analysis revealed that the cost of managing the most extreme situations exceeded $1 million.
"The 2010 American Heart Association/Heart Rhythm Society Scientific Statement on Cardiac Implantable Electronic Device (CIED) Infections and their Management identified a need for more precise data on the impact and economic burden of pacemaker and defibrillator infections," says Daniel Lerner, MD, chief medical officer of TYRX Inc. "This large population study in a broad spectrum of patients provides important information on the significant impact that cardiac device infections have on morbidity, mortality and health care costs. These findings further underscore the need for infection prevention as a key component of medical cost control."
The new study was conducted with financial support from TYRX , Inc.