Racial and ethnic healthcare disparities in patients undergoing laser lead extraction

Yasser Rodriguez, Francisco Irizarry, Roger Carrillo

Research output: Contribution to journalArticle

Abstract

Background: The rate of cardiovascular implantable electronic device infections (CIEDIs) has mirrored or exceeded the increased use of implantable cardiac devices in the United States. The presence of racial and ethnic disparities associated with CIEDIs has not been published. Our aim is to describe the presence of racial and ethnic disparities with respect to the management of CIEDIs. Methods: We reviewed a prospective single-center registry for patients undergoing removal of an implantable cardiac device between 1/2004 and 1/2016. 1173 consecutive patients underwent device extraction. 699 patients were identified as having an infection, 305 were identified as Caucasian and 394 were minorities (91 African Americans, 303 Hispanics). Patients had pre-operative transesophageal echocardiograms (TEEs) and collection of blood and exudate cultures. All underwent complete hardware extraction; leads were removed through the use of locking stylets and traction or laser extraction. En-bloc capsulectomy was performed with intraoperative specimen collection from pocket tissue, exudate, lead tips, and vegetations. Results: Minority patients were: younger (67.9 ± 14.5 years vs 72.4 ± 13.2 years), had a higher proportion of male gender, diabetes, and chronic renal failure (p < 0.001). Minorities experienced a higher rate of complications during extraction and a longer hospitalization (15.3 ± 9.9 days versus 17.4 ± 13.4 days, p < 0.001). There was no significant difference between the proportion of types of infection in both groups. Conclusion: Minority patients with CIEDIs experienced more procedural complications during extraction and had a significantly longer length of index hospitalization than Caucasian patients.

Original languageEnglish (US)
JournalInternational Journal of Cardiology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Healthcare Disparities
Lasers
Equipment and Supplies
Infection
Exudates and Transudates
Hospitalization
Specimen Handling
Traction
Lead
Hispanic Americans
African Americans
Chronic Kidney Failure
Registries

Keywords

  • Complication
  • Defibrillators
  • Disparities
  • Extraction
  • Infection
  • Minority groups
  • Pacemaker, artificial

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Racial and ethnic healthcare disparities in patients undergoing laser lead extraction. / Rodriguez, Yasser; Irizarry, Francisco; Carrillo, Roger.

In: International Journal of Cardiology, 01.01.2018.

Research output: Contribution to journalArticle

@article{ad32713381ec41039feae7e928de906e,
title = "Racial and ethnic healthcare disparities in patients undergoing laser lead extraction",
abstract = "Background: The rate of cardiovascular implantable electronic device infections (CIEDIs) has mirrored or exceeded the increased use of implantable cardiac devices in the United States. The presence of racial and ethnic disparities associated with CIEDIs has not been published. Our aim is to describe the presence of racial and ethnic disparities with respect to the management of CIEDIs. Methods: We reviewed a prospective single-center registry for patients undergoing removal of an implantable cardiac device between 1/2004 and 1/2016. 1173 consecutive patients underwent device extraction. 699 patients were identified as having an infection, 305 were identified as Caucasian and 394 were minorities (91 African Americans, 303 Hispanics). Patients had pre-operative transesophageal echocardiograms (TEEs) and collection of blood and exudate cultures. All underwent complete hardware extraction; leads were removed through the use of locking stylets and traction or laser extraction. En-bloc capsulectomy was performed with intraoperative specimen collection from pocket tissue, exudate, lead tips, and vegetations. Results: Minority patients were: younger (67.9 ± 14.5 years vs 72.4 ± 13.2 years), had a higher proportion of male gender, diabetes, and chronic renal failure (p < 0.001). Minorities experienced a higher rate of complications during extraction and a longer hospitalization (15.3 ± 9.9 days versus 17.4 ± 13.4 days, p < 0.001). There was no significant difference between the proportion of types of infection in both groups. Conclusion: Minority patients with CIEDIs experienced more procedural complications during extraction and had a significantly longer length of index hospitalization than Caucasian patients.",
keywords = "Complication, Defibrillators, Disparities, Extraction, Infection, Minority groups, Pacemaker, artificial",
author = "Yasser Rodriguez and Francisco Irizarry and Roger Carrillo",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.ijcard.2018.07.003",
language = "English (US)",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Racial and ethnic healthcare disparities in patients undergoing laser lead extraction

AU - Rodriguez, Yasser

AU - Irizarry, Francisco

AU - Carrillo, Roger

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: The rate of cardiovascular implantable electronic device infections (CIEDIs) has mirrored or exceeded the increased use of implantable cardiac devices in the United States. The presence of racial and ethnic disparities associated with CIEDIs has not been published. Our aim is to describe the presence of racial and ethnic disparities with respect to the management of CIEDIs. Methods: We reviewed a prospective single-center registry for patients undergoing removal of an implantable cardiac device between 1/2004 and 1/2016. 1173 consecutive patients underwent device extraction. 699 patients were identified as having an infection, 305 were identified as Caucasian and 394 were minorities (91 African Americans, 303 Hispanics). Patients had pre-operative transesophageal echocardiograms (TEEs) and collection of blood and exudate cultures. All underwent complete hardware extraction; leads were removed through the use of locking stylets and traction or laser extraction. En-bloc capsulectomy was performed with intraoperative specimen collection from pocket tissue, exudate, lead tips, and vegetations. Results: Minority patients were: younger (67.9 ± 14.5 years vs 72.4 ± 13.2 years), had a higher proportion of male gender, diabetes, and chronic renal failure (p < 0.001). Minorities experienced a higher rate of complications during extraction and a longer hospitalization (15.3 ± 9.9 days versus 17.4 ± 13.4 days, p < 0.001). There was no significant difference between the proportion of types of infection in both groups. Conclusion: Minority patients with CIEDIs experienced more procedural complications during extraction and had a significantly longer length of index hospitalization than Caucasian patients.

AB - Background: The rate of cardiovascular implantable electronic device infections (CIEDIs) has mirrored or exceeded the increased use of implantable cardiac devices in the United States. The presence of racial and ethnic disparities associated with CIEDIs has not been published. Our aim is to describe the presence of racial and ethnic disparities with respect to the management of CIEDIs. Methods: We reviewed a prospective single-center registry for patients undergoing removal of an implantable cardiac device between 1/2004 and 1/2016. 1173 consecutive patients underwent device extraction. 699 patients were identified as having an infection, 305 were identified as Caucasian and 394 were minorities (91 African Americans, 303 Hispanics). Patients had pre-operative transesophageal echocardiograms (TEEs) and collection of blood and exudate cultures. All underwent complete hardware extraction; leads were removed through the use of locking stylets and traction or laser extraction. En-bloc capsulectomy was performed with intraoperative specimen collection from pocket tissue, exudate, lead tips, and vegetations. Results: Minority patients were: younger (67.9 ± 14.5 years vs 72.4 ± 13.2 years), had a higher proportion of male gender, diabetes, and chronic renal failure (p < 0.001). Minorities experienced a higher rate of complications during extraction and a longer hospitalization (15.3 ± 9.9 days versus 17.4 ± 13.4 days, p < 0.001). There was no significant difference between the proportion of types of infection in both groups. Conclusion: Minority patients with CIEDIs experienced more procedural complications during extraction and had a significantly longer length of index hospitalization than Caucasian patients.

KW - Complication

KW - Defibrillators

KW - Disparities

KW - Extraction

KW - Infection

KW - Minority groups

KW - Pacemaker, artificial

UR - http://www.scopus.com/inward/record.url?scp=85049575761&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85049575761&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2018.07.003

DO - 10.1016/j.ijcard.2018.07.003

M3 - Article

AN - SCOPUS:85049575761

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -