NHLBI-NIAID working group on antimicrobial strategies and cardiothoracic surgeryIncreasing rates of cardiac device infections among medicare beneficiaries: 1990–1999☆
Section snippets
Methods
We analyzed claims files from the Health Care Finance Administration for Medicare beneficiaries from January 1, 1990, through December 31, 1999, to identify patients receiving Medicare benefits who had device infections using the Medicare Provider Analysis and Review (MEDPAR) data files. International Classification of Disease, 9th edition (ICD-9) codes and Diagnostic Related Group (DRG) codes were used to identify patients with a cardiac device (prosthetic heart valves, 352.0–352.8; permanent
Patient sample characteristics
The basic characteristics of the patients undergoing cardiac device implantation are given in Table I.The number of patients with implantations was 22,152 in 1990, but rose substantially during the study period to 36,310 in 1999. In addition, the population undergoing these procedures also showed an increase in mean age during the study period (Table I). In all years, most patients were male and white.
Rates of prosthetic valve/cardiac device implantation and infection: 1990–1999
From 1990 to1999, cardiac device implantation rates increased by 42%, from 3.26 procedures per
Discussion
Implantation of a cardiac device can offer lifesaving therapy to patients with various cardiovascular diseases, but these procedures carry significant risks, including infection. In this study, population-based data were used to better understand the extent of the infection risk posed by an increasing use of these devices. This study addresses changes in both the size of the population at risk for device infections and the rates of device infections with 2 key observations.
First, the number of
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Supported by grants K23 HL70861-01 (C.H.C.), AHA BGIA 0265405U (C.H.C.), K23 AI-01647 (V.G.F.), and a Career Development Award from the VA Health Services Research and Development Service (P.H.).