1. Use of healthcare claims to validate the Prevention of Arrhythmia Device Infection Trial cardiac implantable electronic device infection risk score
- Author
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Charles J. Love, Arnold J. Greenspon, François Philippon, Christopher Cooper, Heather L. Bloom, Fozia Z Ahmed, Khaldoun G. Tarakji, Jens Brock Johansen, Carina Blomström-Lundqvist, Daniel R. Lexcen, Andrew D. Krahn, Ying Xia, Christopher Ellis, Andreas Goette, Lou Sherfesee, Reece Holbrook, and Swathi Seshadri
- Subjects
Adult ,Pacemaker, Artificial ,medicine.medical_specialty ,Infection risk ,Prosthesis-Related Infections ,Adolescent ,medicine.medical_treatment ,Implantable cardioverter-defibrillator ,Health claims on food labels ,Risk Factors ,Clinical Research ,Pacing and Cardiac Resynchronization Therapy ,Physiology (medical) ,Internal medicine ,Health care ,medicine ,Humans ,AcademicSubjects/MED00200 ,Cardiac and Cardiovascular Systems ,Retrospective Studies ,Kardiologi ,Framingham Risk Score ,business.industry ,Cardiac arrhythmia ,Arrhythmias, Cardiac ,Targeted interventions ,Predictive value ,Defibrillators, Implantable ,Pacemaker ,Risk score ,Electronics ,Infection ,Cardiology and Cardiovascular Medicine ,business ,Delivery of Health Care - Abstract
Aim The Prevention of Arrhythmia Device Infection Trial (PADIT) infection risk score, developed based on a large prospectively collected data set, identified five independent predictors of cardiac implantable electronic device (CIED) infection. We performed an independent validation of the risk score in a data set extracted from U.S. healthcare claims. Methods and results Retrospective identification of index CIED procedures among patients aged ≥18 years with at least one record of a CIED procedure between January 2011 and September 2014 in a U.S health claims database. PADIT risk factors and major CIED infections (with system removal, invasive procedure without system removal, or infection-attributable death) were identified through diagnosis and procedure codes. The data set was randomized by PADIT score into Data Set A (60%) and Data Set B (40%). A frailty model allowing multiple procedures per patient was fit using Data Set A, with PADIT score as the only predictor, excluding patients with prior CIED infection. A data set of 54 042 index procedures among 51 623 patients with 574 infections was extracted. Among patients with no history of prior CIED infection, a 1 unit increase in the PADIT score was associated with a relative 28% increase in infection risk. Prior CIED infection was associated with significant incremental predictive value (HR 5.66, P, Graphical Abstract
- Published
- 2021