Surgical outcomes of infective endocarditis among intravenous drug users

Kim, Joon Bum; Ejiofor, Julius I.; Yammine, Maroun; Ando, Masahiko; Camuso, Janice; Youngster, Ilan; Nelson, Sandra; Kim, Arthur Y.; Melnitchouk, Serguei; Rawn, James D.; MacGillivray, Thomas E.; Cohn, Lawrence H.; Byrne, John G.; Sundt, Thoralf M.

doi:10.1016/j.jtcvs.2016.02.072

Cited by 126 publications

(146 citation statements)

References 33 publications

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“…In the combined IIA and splenic group, survival was less but this may reflect a more extensive disease process. Although we did not find any difference between outcome of IVDAs and non‐IVDAs, it was reported that IVDAs are at high risk of reinfection and late mortality . The IVDA patients may have pulmonary emboli, leading to a higher rate of morbidity .…”

Section: Discussioncontrasting

confidence: 66%

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Management of Septic emboli in patients with infectious endocarditis

et al. 2017

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Section: Discussioncontrasting

confidence: 66%

“…Although we did not find any difference between outcome of IVDAs and non-IVDAs, it was reported that IVDAs are at high risk of reinfection and late mortality. 43 The IVDA patients may have pulmonary emboli, leading to a higher rate of morbidity. 44 Moreover, IVDAs are at higher risk of human immunodeficiency virus infection.…”

Section: Discussionmentioning

confidence: 99%

Management of Septic emboli in patients with infectious endocarditis

et al. 2017

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“…We also focused our analysis on the impact of referral to addiction services on survival. Optimization of treatment strategies in this population is important given the increasing frequency of injection drug use, 18,19,20 hospitalizations related to injection drug use, 8,21,22 and injection drug use–associated IE. 7,12 …”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Factors Associated With Mortality in First-Episode Infective Endocarditis Among Persons Who Inject Drugs

et al. 2018

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Key Points Question In first-episode infective endocarditis in persons who inject drugs, what are the clinical differences between patients who receive surgery vs those who are medically treated, and which factors are associated with mortality? Findings In this case series of 370 first-episode cases of infective endocarditis, the main significant differences between persons who inject drugs who received surgery and those who did not were the site of infection and cardiac complications. Decreased mortality was associated with surgery and referral to addiction treatment services, while higher mortality was associated with left-sided and bilateral infections. Meaning In selected persons who inject drugs with first-episode endocarditis, surgical management and referral to addiction treatment were associated with reduced mortality.

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“…2,[5][6][7] Patients admitted with IDU-associated infections have long lengths of stay, high rates of leaving against medical advice (AMA), readmission, and mortality. [8][9][10][11][12][13] In a British cohort (median age 36 years), five-year mortality after an episode of IDU-associated endocarditis was 42%. 14 Admissions for IDU-associated infections can be a troubling experience for both patients and providers alike.…”

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confidence: 99%

New Answers for Old Questions in the Treatment of Severe Infections from Injection Drug Use

Serota

Vettese

2019

Journal of Hospital Medicine

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A s a result of the epidemic of opioid use disorder (OUD), there has been a secondary surge in hospitalizations for infectious complications of injection drug use (IDU). 1,2 In the previous 10 years, there have been significant increases in IDU-associated human immunodeficiency virus (HIV) 3 and hepatitis C virus (HCV) 4 infection as well as increased hospitalizations from IDU-associated skin and soft tissue infections, osteomyelitis, septic arthritis, bacteremia, fungemia, and infective endocarditis in the United States. 2,[5][6][7] Patients admitted with IDU-associated infections have long lengths of stay, high rates of leaving against medical advice (AMA), readmission, and mortality. [8][9][10][11][12][13] In a British cohort (median age 36 years), five-year mortality after an episode of IDU-associated endocarditis was 42%. 14 Admissions for IDU-associated infections can be a troubling experience for both patients and providers alike. 15 While management decisions of IDU-associated infectious syndromes have sometimes been based on emotion, dogma, and an often-stigmatizing approach toward people suffering from addiction, 16 with a better understanding of addiction and effective treatments, as well as accumulating data in both addiction and infectious disease fields, it is an appropriate time to reevaluate the approach to treatment.The goal of this review is to examine recent evidence and attempt to answer questions that frequently arise in the management of hospitalized patients with IDU-associated infections. The questions addressed in this review primarily stem from the discussion of Schranz and colleagues in their description of increasing hospitalizations for IDU-associated endocarditis. 7 Additionally, questions were developed from discussions with practicing academic hospitalists. For each question, a review of the published literature was performed, with a focus on articles published between 2014 and 2019. Finally, a framework for how to approach patients with infectious complications of IDU is presented. As a comprehensive review of infectious complications of OUD would be difficult to cover in one review, this review will focus on eight questions that frequently arise in the care of inpatients.

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Surgical outcomes of infective endocarditis among intravenous drug users

Abstract: The proportion of IVDUs among surgically treated IE patients is increasing. Although IVDUs have lower operative risk, long-term outcomes are compromised by reinfection.

Cited by 126 publications

References 33 publications

Management of Septic emboli in patients with infectious endocarditis

Management of Septic emboli in patients with infectious endocarditis

Clinical Characteristics and Factors Associated With Mortality in First-Episode Infective Endocarditis Among Persons Who Inject Drugs

New Answers for Old Questions in the Treatment of Severe Infections from Injection Drug Use

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