Introduction:
Several studies have shown inconsistent relationship between post-implantation hematoma (PH) and cardiac implantable electronic device (CIED) infection. In this study, we performed a systematic review and meta-analysis to explore the effect of PH and the risk of CIED infection.
Hypothesis:
PH increases the risk of CIED infection.
Methods:
We searched the databases of MEDLINE and EMBASE from inception to March 2020. Included studies were cohort studies, case-control studies, cross-sectional studies and randomized controlled trials that reported incidence of PH and CIED infection during the follow-up period. CIED infection was defined as either a device-related local or systemic infection. Data from each study were combined using the random-effects, generic inverse variance method of Der Simonian and Laird to calculate odds ratios (OR) and 95% confidence intervals (CI).
Results:
Fourteen studies from 2006 to 2018 were included, involving a total of 28,319 participants. There were 6 cohort studies, 7 case-control studies and 1 randomized controlled trial. In random-effect model, we found that PH significantly increases the risk of overall CIED infection (OR = 6.30, 95%CI: 3.87-10.24, I2=49.3%) (Figure 1). There was no publication bias observed in the funnel plot as well as no small-study effect observed in Egger’s test.
Conclusions:
Our meta-analysis demonstrated that PH significantly increases the risk of CIED infection. Precaution should be taken to during device implantation to reduce PH and subsequent CIED infection.
Brucella cardiac implantable electronic device infection: A single-center case series
