Assessing the Effectiveness of the PADIT Score in Predicting CIED Infections: Insights from a Tertiary Care Center

Objectives: To assess the utility of the PADIT score in identifying patients at higher risk of developing CIED-related infections within a six-month follow-up period at a tertiary academic medical center. Methodology: This prospective, descriptive, single-center study enrolled 168 consecutive adult patients who underwent pacemaker, implantable cardioverter-defibrillator (ICD), or cardiac resynchronization therapy defibrillator/pacemaker (CRT-D/CRT-P) placement or generator renewal between June and December 2023 at a tertiary medical center in Pakistan. The primary outcome was hospital admission due to confirmed CIED or pocket infection within six months post-implantation. Results: The study analyzed data from 168 patients (mean age: 64.6 ± 14.43 years; 50.7% male, 49.3% female), revealing a generally low prevalence of pre-existing risk factors. The mean PADIT (Prevention of Arrhythmia Device Infection Trial) score was 1.18 ± 1.65, indicating a predominantly low-risk profile. Three patients (1.7%) developed CIED infections, and only one of these cases was classified as high-risk with a PADIT score >7. The score demonstrated poor predictive performance, with a C-statistic of 0.413 (95% CI). Conclusion: The PADIT score did not effectively identify patients at increased risk of CIED-related infections within a six-month follow-up in this single-center prospective study. Further research may be needed to explore additional risk factors and improve risk stratification models for this patient population.