Adults with congenital heart disease hospitalized for infective endocarditis had significantly lower mortality (5.4% vs. 9.5%; OR 0.54, 95% CI 0.47-0.63) compared to the general population.
Cross-Sectional (n=1,096,858)
Yes
Does the presence of congenital heart disease affect in-hospital mortality and surgery rates in adults hospitalized for infective endocarditis compared to the general population?
Adults with congenital heart disease hospitalized for infective endocarditis have lower in-hospital mortality but higher rates of surgical intervention compared to the general population.
Odds Ratio: 0.54 (95% CI 0.47–0.63)
Absolute Event Rate: 5.4% vs 9.5%
p-value: p=< 0.001
Abstract Background: Given increased survival for adults with CHD, we aim to determine outcome differences of infective endocarditis compared to patients with structurally normal hearts in the general population. Methods: We conducted a retrospective cross-sectional study identifying infective endocarditis hospitalisations in patients 18 years and older from the National Inpatient Sample database between 2001 and 2016 using International Classification of Disease diagnosis and procedure codes. Weighting was used to create national annual estimates indexed to the United States population, and multivariable logistic regression analysis determined variable associations. Outcome variables were mortality and surgery. The primary predictor variable was the presence or absence of CHD. Results: We identified 1,096,858 estimated infective endocarditis hospitalisations, of which 17,729 (1.6%) were adults with CHD. A 125% increase in infective endocarditis hospitalisations occurred for adult CHD patients during the studied time period ( p < 0.001). Adults with CHD were significantly less likely to experience mortality (5.4% vs. 9.5%, OR 0.54, CI 0.47–0.63, p < 0.001) and more likely to undergo in-hospital surgery (31.6% vs. 6.7%, OR 6.49, CI 6.03–6.98, p < 0.001) compared to the general population. CHD severity was not associated with increased mortality ( p = 0.53). Microbiologic aetiology of infective endocarditis varied between groups ( p < 0.001) with Streptococcus identified more commonly in adults with CHD compared to patients with structurally normal hearts (36.2% vs. 14.4%). Conclusions: Adults with CHD hospitalised for infective endocarditis are less likely to experience mortality and more likely to undergo surgery than the general population.
Byrne et al. (Thu,) conducted a cross-sectional in Infective endocarditis (n=1,096,858). Congenital heart disease (CHD) vs. Structurally normal hearts (general population) was evaluated on Mortality (OR 0.54, 95% CI 0.47-0.63, p=< 0.001). Adults with congenital heart disease hospitalized for infective endocarditis had significantly lower mortality (5.4% vs. 9.5%; OR 0.54, 95% CI 0.47-0.63) compared to the general population.