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.

Full Text

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