Posted on 04/06/2022 7:10:37 AM PDT by ConservativeMind
Medicare patients whose implantable heart devices became infected were less likely to die from the complication if they had the hardware removed compared to patients who only received antibiotics, according to the largest study on the topic.
The study showed that just 18% of patients with device infections underwent surgeries to have their pacemakers or defibrillators removed, even though removal is recommended by all leading medical society treatment guidelines. There is a 43% lower risk of death in these patients if guidelines are followed.
The findings highlight that cardiac device infection is a major public health issue, and there are large gaps in guideline adherence.
Of those study patients, 11,619 (about 1%) developed infections a year or more after implantation. Only 13% of the patients had the device removed within six days of infection, and an additional 5% had them removed from day seven to 30.
The vast majority—nearly 82%—were treated solely with antibiotics, despite numerous earlier studies showing antibiotics fail to wipe out infections involving CIEDs.
Those earlier studies led to a 2017 consensus of leading health organizations to recommend removal of CIEDs when a definitive infection is identified.
In the current study, the researchers found that removing the devices had a clear survival benefit. The death rate for those who did not have their devices removed was 32.4% in the year after an infection was diagnosed, compared with a rate of 18.5% among patients who underwent extraction within six days and 23.2% for patients who had extractions on days seven to 30.
"Any extraction was associated with lower mortality when compared to no extraction, but the highest benefit was to those who had devices removed within six days of an infection," Pokorney said.
(Excerpt) Read more at medicalxpress.com ...
Fire your doctor if you can’t get them to properly handle your health. They obviously are not staying educated on their chosen profession.
Lemme guess:
These devices were ‘approved’ by the FDA. /s
bkmk
Even better if they’re fluoroquinolone antibiotics, so you run the risk of tendon ruptures.
Wonder if the 18% were patients with MediGap insurance..?
What is not known is how many doctors actually recommended removal but the patient refused. Informed consent for surgery requires all the risks of removal be disclosed. Removal of pacemaker or defibrillator leads is not trivial; cardiac laceration, tamponade and death have occurred. Additionally, the patient is left without the benefits of the device for a period of time. After hearing this, even after being told that overall the risk of removal is less than the risk of leaving it in, there are patients that will decline. I have patients refuse my recommendations all the time. This is an aspect of modern medicine that is problematic. Doctors are being judged on outcomes only, disregarding the patient responsibility aspect. Refusing recommended procedures, continuing unhealthy behaviors such as smoking, being noncompliant with medicines are all ways that patient sabatoge their own health.
Her cause of death has not been released.
I’m on my third device now and have had no problems. The first was implanted in 2007.
https://dcri.org/acc22-few-patients-have-infected-heart-devices-removed-despite-lifesaving-benefits/
No link to the study, however.
Ping to my reply #8.
I know that in the case of my mom who has a pacemaker after a triple bypass surgery (proceeded by two attempts at shunting), she has said repeatedly that she would rather die than have another surgery.
Those are very reasonable points to make against the way this was described.
With a very high death rate now understood, this should light a fire under patients to help do the right thing.
Thankfully, infection appears to only happen 1% of the time.
May you continue your success rate!
Doctors not staying updated on the latest research is not uncommon.
This is very likely out of left field. But here goes.
Is it possible that the devices trigger a hyper immune response leading to autoimmune disease (of sorts) making the patient more vulnerable to bacterial infections?
Don’t think so. Infections of prosthetic devices of all sorts are very common. Some bacteria are able to create a biofilm, a slime of sorts that sticks to artificial materials and creates a barrier to the body’s immune response. Antibiotics can keep the infection low-grade but rarely completely eliminate it. That’s why it’s best just to remove the device completely, be it a pacemaker/defibrilator, artificial hip, or prosthetic hernia mesh, etc.
“Removal of pacemaker or defibrillator leads is not trivial; cardiac laceration, tamponade and death have occurred.”
Yep,i had a pacemaker replacement a year and a half ago and it was a tricky operation removing the leads. My doc was quite concerned about causing damage when yanking out the leads that had become enmeshed with heart tissue. Luckily everything worked out.
They need to coat these devices with colloidal silver.
Thanks for your kind and patient answer. My late mother in law was wheelchair bound after her knee replacement became infected. She remained on antibiotics for several years until her passing.
Next weird question. Am I wrong in thinking that specially grown bacterial biolfilms would be of use in cleaning oil spills and such?
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