For Clinicians

Consequences of CIED infection on patients and the healthcare system

  • The risk-adjusted admission mortality with infection was 4.6% to 11.3% depending on the CIED type (4.8- to 7.7-fold the mortality without infection).1
  • The risk-adjusted, longer-term mortality rate (admission quarter plus subsequent 4 quarters) with infection was 26.5% to 35.1%, with 50% occurring after discharge.1
  • The risk-adjusted average length of stay (LOS) with infection was 15.5 to 24.3 days.1
  • The Centers for Medicare & Medicaid Services (CMS) estimate that the average cost of a CIED infection is ~$52,000 and consider the condition to be high cost and high volume.2

Risk adjusted mortality rates
Risk adjusted mortality rates1

Survival rate for CIED procedures with and without infections

Infections typically cost the facility an average of ~$52,0002 but may exceed well over $100,000.1

  • Treating CIED infections is complex and expensive.1,3
  • The AHA Update on CIED Infections and Their Management reports: “The economic consequences, including healthcare resource utilization, of CIED infections are substantial.”3
  • As of October 1, 2012, the Centers for Medicaid and Medicare Services (CMS) has reduced payments to hospitals when a patient undergoing a CIED procedure acquired an infection during their hospital stay.2
  • As part of the Heart Rhythm Society (HRS) Performance Measurement Development Initiative, new physician-level performance measure coding-level specifications and code recommendations were developed and finalized in July 2012, including HRS-9: Infection within 180 days of CIED Implantation, Replacement, or Revision. This proposal became active in 2015.4
  • This information is intended to ensure that Electrophysiologists (EPS) are accountable to their patients, and that EPS are ready to participate in the Physician Quality Reporting System (PQRS), which has become mandatory in 2015. Under the PQRS, individual physician performance will be publicly reported and reimbursement will be linked to reporting on performance measures.4

Cost to treat cied infections chart
Cost to treat CIED infections chart1,2,5


References

  1. Sohail MR et al. PACE.2015;38(2):231-239.
  2. Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services Inpatient Prospective Payment System (IPPS) Final Rule FY13.
  3. Baddour LM et al. Circulation. 2010;121(3):458-477.
  4. Heart Rhythm Society (HRS) Performance Measurement Development Initiative. Cycle 2, 2012.
  5. Based on TYRX analysis of the Medicare Standard Analysis File (SAF) for 2008 in patient claims, performed in conjunction with the health care consulting firm Braide-Forbes Health Research.