Objectives To evaluate the cost-effectiveness of early lead extraction (≤7 days post-admission) compared with delayed (>7 days) or no extraction for cardiac implantable electronic device (CIED) infections in the UK using a decision-analytic model from the NHS perspective. Design A decision-tree model was constructed to simulate clinical and economic outcomes in adult patients with systemic or pocket CIED infections.
Setting Secondary care hospital setting within the UK NHS. Participants A simulated cohort of adult patients with systemic or pocket CIED infections.
Model inputs were sourced from published literature and NHS cost data (2023 £). Interventions Early lead extraction (≤7 days after diagnosis/admission) compared with delayed extraction (>7 days) or no extraction.
Primary and secondary outcome measures Adverse events avoided and total healthcare costs over a 1-year time horizon; deterministic and probabilistic sensitivity analyses were conducted to assess model robustness. Results Early extraction was both clinically and economically superior to delayed or no extraction.
BMJ Open published a clinical update in Research Highlights on 24 Apr 2026.
The item focuses on Cost-effectiveness modelling of early lead extraction for cardiac implantable electronic device infections in the United Kingdom.
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