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Surgical Replacement of Implantable Pulse Generator in Deep Brain Stimulation: Adverse Events and Risk Factors in a Multicenter Cohort
Karolinska Institute, Sweden; Umeå University, Sweden; University of Queensland, Australia.
University of Queensland, Australia.
Umeå University, Sweden; Sahlgrens University Hospital, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Neurosurgery.
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2016 (English)In: Stereotactic and Functional Neurosurgery, ISSN 1011-6125, E-ISSN 1423-0372, Vol. 94, no 4, 235-239 p.Article in journal (Refereed) Published
Abstract [en]

Background: Deep brain stimulation (DBS) is a growing treatment modality, and most DBS systems require replacement of the implantable pulse generator (IPG) every few years. The literature regarding the potential impact of adverse events of IPG replacement on the longevity of DBS treatments is rather scarce. Objective: To investigate the incidence of adverse events, including postoperative infections, associated with IPG replacements in a multicenter cohort. Methods: The medical records of 808 patients from one Australian and five Swedish DBS centers with a total of 1,293 IPG replacements were audited. A logistic regression model was used to ascertain the influence of possible predictors on the incidence of adverse events. Results: The overall incidence of major infections was 2.3% per procedure, 3.7% per patient and 1.7% per replaced IPG. For 28 of 30 patients this resulted in partial or complete DBS system removal. There was an increased risk of infection for males (OR 3.6, p = 0.026), and the risk of infection increased with the number of prior IPG replacements (OR 1.6, p amp;lt; 0.005). Conclusions: The risk of postoperative infection with DBS IPG replacement increases with the number of previous procedures. There is a need to reduce the frequency of IPG replacements. (C) 2016 S. Karger AG, Basel

Place, publisher, year, edition, pages
KARGER , 2016. Vol. 94, no 4, 235-239 p.
Keyword [en]
Deep brain stimulation; Implantable pulse generator; Hardware; Adverse event; Complication; Postoperative infection; Surgical site infection
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-133022DOI: 10.1159/000447521ISI: 000387199800005PubMedID: 27554079OAI: oai:DiVA.org:liu-133022DiVA: diva2:1054656
Note

Funding Agencies|Umea University; Foundation for Clinical Neuroscience at the University Hospital of Umea; Foundation for Clinical Research of the Stockholm County Council

Available from: 2016-12-08 Created: 2016-12-07 Last updated: 2016-12-08

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Zsigmond, Peter
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Division of Neuro and Inflammation ScienceFaculty of Medicine and Health SciencesDepartment of Neurosurgery
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