Abstract 4145033: Trends in-hospital mortality and 90-day outcomes in cardiac implantable electronic device management amongst patients with and without ERSD, a national analysis

Background: Cardiac implantable electronic device (CIED) infections pose risks, with outcomes potentially influenced by underlying comorbidities such as end-stage renal disease (ESRD). Objective: To evaluate the differences in clinical outcomes of CIED-infection management between patients with and without ESRD. Methods: From 2016 to 2020, we employed the National Readmission Database to identify patients ≥18 years of age who were admitted with CIED-related infections. CIED/lead extraction was defined as a composite of extraction of device, with or without revision or replacement in index hospitalization. Patients were stratified based on ESRD status. Results: Patients with ESRD had a higher rate of mortality in index hospitalization than no-ESRD (14.82%, vs 5.95%, p<0.001). CIED-related infection was the leading cause of readmission in both groups (40.7% vs 79.5%). 90-day readmission mortality (6.5% vs. 3.7%, p=0.458) and hospital readmission rates (1.09% vs 1.46%, p=289) were comparable between ESRD vs no- ESRD patients. ESRD patients had longer length of stay (29.5 vs. 16.8 days, p<0.001) and higher total charges ($559185 vs. $317353, p<0.001). Over a 5-year period, CIED extraction rates remained unchanged, with no improvement in its associated mortality (p=0.805). Conclusion: CIED-related infections in ESRD patients have nearly a 3-fold increase in mortality during index hospitalization but no significant differences were observed during a 90-day mortality.