Infective endocarditis complicated by concurrent heart block was associated with increased in-hospital mortality (13% vs 10.3%), longer length of stay, and higher costs compared to those without.
Observational (n=18,733)
Yes
Does concurrent heart block worsen in-hospital outcomes in patients with infective endocarditis?
Concurrent heart block in infective endocarditis is associated with significantly worse in-hospital outcomes, including higher mortality, longer length of stay, and increased need for cardiac interventions.
Absolute Event Rate: 13% vs 10.3%
Infective endocarditis (IE) complicated by heart block can have adverse outcomes and usually requires immediate surgical and cardiac interventions. Data on outcomes and trends in patients with IE with concurrent heart block are lacking. Patients with a primary diagnosis of IE with or without heart block were identified by querying the Healthcare Cost and Utilization Project database, specifically the National Inpatient Sample for the years 2013 and 2014, based on International Classification of Diseases Clinical Modification Ninth Revision codes. During 2013 and 2014, a total of 18, 733 patients were admitted with a primary diagnosis of IE, including 867 with concurrent heart blocks. Increased in-hospital mortality (13% vs 10. 3%), length of stay (19 vs 14 days), and cost of care (282, 573 vs 223, 559) were found for patients with IE complicated by heart block. Additionally, these patients were more likely to develop cardiogenic shock (8. 9% vs 3. 2%), acute kidney injury (40. 1% vs 32. 6%), and hematologic complications (19. 3% vs 15. 2%), and require placement of a pacemaker (30. 6% vs 0. 9%). IE and concurrent heart block resulted in increased requirement for aortic (25. 7% vs 6. 1%) and mitral (17. 3% vs 4. 2%) valvular replacements. Conclusion was made that IE with concurrent heart block worsens in-hospital mortality, length of stay, and cost for patients. Our analysis demonstrates an increase in cardiac procedures, specifically aortic and/or mitral valve replacements, and Implantable Cardiovascular Defibrillator/Cardiac Resynchronization Therapy/ Permanent Pacemaker (ICD/CRT/PPM) placement in IE with concurrent heart block. A close telemonitoring system and prompt interventions may represent a significant mitigation strategy to avoid the adverse outcomes observed in this study.
Jamal et al. (Wed,) conducted a observational in Infective endocarditis (n=18,733). Concurrent heart block vs. Without heart block was evaluated on In-hospital mortality. Infective endocarditis complicated by concurrent heart block was associated with increased in-hospital mortality (13% vs 10.3%), longer length of stay, and higher costs compared to those without.