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Surgical Replacement of Implantable Pulse Generator in Deep Brain Stimulation : Adverse Events and Risk Factors in a Multicenter Cohort

Fytagoridis, Anders (author)
Karolinska Institutet,Umeå universitet,Klinisk neurovetenskap,Neurosurgery, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm. Asia-Pacific Centre for Neuromodulation, Queensland Brain Institute, University of Queensland,Karolinska Inst, Dept Clin Neurosci, Neurosurg, Stockholm, Sweden.;Umeå Univ, Dept Pharmacol & Clin Neurosci, Unit Funct & Stereotact Neurosurg, Umeå, Sweden.;Univ Queensland, Queensland Brain Inst, Asia Pacific Ctr Neuromodulat, Brisbane, Qld 4072, Australia.,Karolinska Institute, Sweden; Umeå University, Sweden; University of Queensland, Australia
Heard, Tomas (author)
Univ Queensland, Queensland Brain Inst, Asia Pacific Ctr Neuromodulat, Brisbane, Qld 4072, Australia.,University of Queensland, Australia
Samuelsson, Jennifer (author)
Umeå universitet,Klinisk neurovetenskap,Department of Neurosurgery, Sahlgrenska University Hospital, Göteborg,Umeå Univ, Dept Pharmacol & Clin Neurosci, Unit Funct & Stereotact Neurosurg, Umeå, Sweden.;Sahlgrens Univ Hosp, Dept Neurosurg, Gothenburg, Sweden.,Umeå University, Sweden; Sahlgrens University Hospital, Sweden
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Zsigmond, Peter (author)
Linköpings universitet,Avdelningen för neuro- och inflammationsvetenskap,Medicinska fakulteten,Region Östergötland, Neurokirurgiska kliniken US
Jiltsova, Elena (author)
Uppsala universitet,Neurokirurgi,University of Uppsala Hospital, Sweden
Skyrman, Simon (author)
Karolinska Institutet
Skoglund, Thomas (author)
Sahlgrens Univ Hosp, Dept Neurosurg, Gothenburg, Sweden.,Sahlgrens University Hospital, Sweden
Coyne, Terry (author)
Univ Queensland, Queensland Brain Inst, Asia Pacific Ctr Neuromodulat, Brisbane, Qld 4072, Australia.;Brizbrain & Spine, Brisbane, Qld, Australia.,University of Queensland, Australia; Brizbrain and Spine, Australia
Silburn, Peter (author)
Univ Queensland, Queensland Brain Inst, Asia Pacific Ctr Neuromodulat, Brisbane, Qld 4072, Australia.,University of Queensland, Australia
Blomstedt, Patric (author)
Umeå universitet,Klinisk neurovetenskap,Umeå Univ, Dept Pharmacol & Clin Neurosci, Unit Funct & Stereotact Neurosurg, Umeå, Sweden.,Umeå University, Sweden
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 (creator_code:org_t)
2016-08-24
2016
English.
In: Stereotactic and Functional Neurosurgery. - : S. Karger AG. - 1011-6125 .- 1423-0372. ; 94:4, s. 235-239
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • 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 < 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.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Neurosciences (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Keyword

Deep brain stimulation
Implantable pulse generator
Hardware
Adverse event
Complication
Postoperative infection
Surgical site infection

Publication and Content Type

ref (subject category)
art (subject category)

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