Key result
PADIT score outperforms PACE DRAP in predicting cardiac device infections with an AUC of ~0.98.
Why the study?
The prognostic accuracy and clinical applicability of PADIT and PACE DRAP scores for predicting long-term infectious complications after CIED implantation were not systematically assessed.
Does the PADIT score improve the prediction of cardiac device infection compared to the PACE DRAP score in patients undergoing CIED implantation?
Cohort (n=405)
No
Does the PADIT score improve the prediction of cardiac device infection compared to the PACE DRAP score in patients undergoing CIED implantation?
Effect estimate: AUC 0.975 (95% CI 0.941-1.000)
p-value: p=<0.001
The PADIT risk score demonstrates significantly superior discriminative ability compared to the PACE DRAP score for predicting long-term cardiac device infections following CIED implantation.
Supports PADIT over PACE DRAP for CIED infection risk stratification in this cohort; hypothesis-generating and requires prospective validation before clinical adoption.
Objective: To systematically assess prognostic accuracy and clinical applicability of PADIT score as well as PACE DRAP scores in predicting long-term infectious complications following cardiac implantable electronic device (CIED) procedure. Study Design: Prospective analytical study Place and Duration of Study: Electrophysiology department of Armed Forces Institute of Cardiology and National Institute of Heart Diseases at Rawalpindi, Pakistan from Jan 2024 to Jan 2025. Methodology: The study included 405 patients undergoing cardiac devices implantation. Demographic, clinical and laboratory characteristics were assessed. Patients were categorized in groups based on predetermined criteria in accordance with guidelines. Results: Overall incidence of cardiac device infection (CDI) was 3.2% (n=13). The PADIT score correlated better with presence of device infections. PADIT score demonstrated better discriminative ability for device infections (AUC of 0.975; 95% CI: 0.941–1.000; p < .001) as compared with PACE DRAP score which showed poor predictive performance for CIED infction (AUC: 0.637; 95% CI: 0.491–0.783; p = .066). Conclusions: Our study depicted that PADIT score discriminated patients at greater risk for CDI better as compared to PACE DRAP score. Type of procedure including lead revision and system upgrade as well as number of procedures on same pocket increased odds of infection significantly.
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Mehreen et al. (2026) conducted a cohort in Cardiac implantable electronic device (CIED) implantation (n=405). PADIT score vs. PACE DRAP score was evaluated on Discriminative ability for cardiac device infections (AUC) (AUC 0.975, 95% CI 0.941-1.000, p=<0.001). The PADIT score demonstrated strong discriminative ability for predicting cardiac device infections (AUC 0.975) compared to the PACE DRAP score (AUC 0.637).
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