Infective endocarditis and solid organ transplantation: Only worse outcomes during initial transplantation hospitalization.
Journal Article (Journal Article)
BACKGROUND: The epidemiology, and outcome of infective endocarditis (IE) among solid organ transplant (SOT) recipients is unknown. METHODS: We used data from the 2013-2018 Nationwide Readmissions Database (NRD). IE- and SOT-associated hospitalizations were identified using diagnosis and procedure codes. Outcomes included inpatient mortality, length of stay, and inpatient costs. Adjusted analyses were performed using weighted regression models. RESULTS: A total of 99,052 IE-associated hospitalizations, corresponding to a weighted national estimate of 193,164, were included for analysis. Of these, 794 (weighted n = 1,574) were associated with transplant history (SOT-IE). Mortality was not significantly different between SOT-IE and non-SOT-IE (17.2% vs. 15.8%, adjusted relative risk [aRR]: 0.86, 95% confidence interval [CI] [0.71, 1.03]), and fewer SOT-IE patients underwent valve repair or replacement than non-SOT-IE (12.5% vs. 16.2%, aRR 0.82, 95% CI [0.71, 0.95]). We then compared outcomes of patients diagnosed with IE during their index transplant hospitalization (index-SOT-IE) to patients without IE during their transplant hospitalization (index-SOT). Index-SOT-IE occurred most frequently among heart transplant recipients (45.1%), and was associated with greater mortality (27.1% vs. 2.3%, aRR 6.07, 95% CI [3.32, 11.11]). CONCLUSION: Dual diagnosis of SOT and IE was associated with worse outcomes among SOT recipients during index hospitalization, but not overall among patients with IE.
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Duke Authors
Cited Authors
- Eichenberger, EM; Dagher, M; Sinclair, MR; Maskarinec, SA; Fowler, VG; Federspiel, JJ
Published Date
- October 2021
Published In
Volume / Issue
- 240 /
Start / End Page
- 63 - 72
PubMed ID
- 34157299
Pubmed Central ID
- PMC8484033
Electronic International Standard Serial Number (EISSN)
- 1097-6744
Digital Object Identifier (DOI)
- 10.1016/j.ahj.2021.06.007
Language
- eng
Conference Location
- United States