Influencing Factors and Prediction of Complications After Implantation of Cardiac Electronic Devices

BACKGROUND: Cardiac implantable electronic device (CIED) related complications occur frequently. Given the uncertainties, a comprehensive investigation of predictive factors is crucial. This study aimed to identify the determinants influencing the occurrence of CIED-related complications and to evaluate their predictive capability for the onset of CIED-related complications. METHODS: This retrospective cohort study recruited 870 patients who underwent CIED implantation. The primary outcome was overall complications, and the secondary was pocket hematomas (PH). Logistic regression model was used to estimate the odds ratio (OR) with the 95% confidence interval (CI), and to establish the prediction models for all complications and PH. RESULTS: 43 cases (4.95%) developed complications during follow-up, including 24 (2.8%) PH and 19 others. After adjusted for potential confounders, body mass index (BMI), having diabetes and chronic kidney disease (CKD), usage of anticoagulants and antiplatelets, device type, device replacement, and device electrode quantities were all associated with the risk of both the complications and PH. The prediction model with these variables displayed a good performance in predicting the complications occurrence, with AUC and C-statistic being 0.886 and 0.886 in training dataset, and 0.780 and 0.761 in the test dataset. Similar good performance in predicting PH onset were also observed. CONCLUSION: The results indicate that BMI, diabetes, CKD, anticoagulants, antiplatelets, device types, device replacement, and device electrode quantities are critical risk factors, which can help predict the onset of the complications and PH.