ArticleCureus2024
Retrospective Review Identifying Patients With Bacteremia and Intracardiac Devices With an Electronic Health Record Advisory.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCardiovascular implantable electronic device (CIED) infections without early diagnosis, treatment, and proper follow-up are associated with increased morbidity, mortality, and worse outcomes. Objective: This study aims to identify patients presenting for hospital admission with bacteremia and the presence of CIED by implementing a best practice advisory (BPA) notification in the electronic medical record to facilitate early consultation with the cardiac electrophysiology (EP) team and treatment.
methodsA BPA was implemented into the electronic medical record (EMR) EPIC in 2022 and was generated for any patient that presented to our health system with bacteremia and the presence of a CIED. The BPA gave the provider an option for EP consultation. Data was collected from EPIC from 2021 to 2023 using the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD10-CM/PCS) codes to identify patients and comorbidities. A comparative analysis was conducted to determine the effectiveness of the BPA in increasing EP consults and cardiac device extraction procedures, as well as overall outcomes.
resultsA total of 447 patients were diagnosed with bacteremia and the presence of a CIED during the study period, with 178 before the BPA and 269 status post-BPA. The BPA resulted in a nonsignificant increase in EP consultations from 19.66% to 25.88% (p = 0.168) and device extractions from 9.55% to 13.75% (p = 0.182). EP consults were a significant predictor for device extractions (odds ratio (OR) = 9.4644, p < 0.0001). The mortality rate decreased from 17.42% to 14.13% (p = 0.419), and the 30-day readmission decreased from 14.37% to 12.41% (p = 0.652).
conclusionWhile the BPA did not show significant improvements, its implementation shows promise over time with positive trends in consults, extractions, and in-hospital mortality.
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