Thirty‐Day Readmission After Infective Endocarditis: Analysis From a Nationwide Readmission Database

Morita, Yusuke; Haruna, Tetsuya; Haruna, Yoshisumi; Nakane, Eisaku; Yamaji, Yuhei; Hayashi, Hideyuki; Hanyu, Michiya; Inoko, Moriaki

doi:10.1161/jaha.118.011598

Cited by 31 publications

(34 citation statements)

References 26 publications

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“…The percentage of positive blood culture and TTE pictures suggestive for IE, according to the Duke modified criteria, observed in our study is due to an earlier alert of an infectious disease consultant closely involved with the hospital team for the management of IE patients. In fact, in our patients, both blood culture and TTE were performed within the first days from admission to the emergency unit, confirming the utility of an early TTE [26,[28][29]. Fever was the main symptom of IE, highlighting that this symptom is vital for the suspicion of IE.…”

Section: Discussionsupporting

confidence: 72%

Infective Endocarditis: Preliminary Results of a Cohort Study in the Southern Italian Population

Serra¹,

Colomba²,

Carlo³

et al. 2020

Cureus

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Background Infective endocarditis (IE) is an uncommon disease with an involved interplay of clinical and surgical team management. We aimed to define diagnosis parameters and delineate in-hospital management in patients with IE admitted in a tertiary hospital of Southern Italian. Materials and methods Fifty-six consecutive patients (42 males, 14 females; age range: 34-85 years) admitted for IE in the Infectious Diseases, Cardiac Surgery, and Cardiology units, between January 2011 and August 2017, were enrolled. Demographic data, mortality, comorbidities, specimen type, microscopy results, special histological staining performed, and antimicrobial therapy were collected and analyzed. Any comments at the multidisciplinary team meetings were recorded in minutes of and approved. Results We found 83.9% of patients with positive blood cultures. The four most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA: 21.3%), methicillin-sensitive Staphylococcus aureus (MSSA: 17%), Streptococci (14.9%), and Enterococci (14.9%). Both in the univariate and multivariate analysis, we observed a significant positive correlation between surgery and complications. Particularly in the univariate analysis only, surgery was positively correlated to males and C-reactive protein (CPR) at baseline. Also, considering the most common bacteria, it resulted in a positive correlation between surgery and MRSA and Streptococci spp. and between complications and MSSA. Finally, the male gender was positively correlated to MSSA and heart complications, major arterial embolism, septic pulmonary emboli, splenic infarction, and cerebral embolism. Conclusions A blood culture test remains a critical factor for the diagnosis of IE and the antibiotic treatment 1 2 2,

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Section: Discussionsupporting

confidence: 72%

Infective Endocarditis: Preliminary Results of a Cohort Study in the Southern Italian Population

Serra¹,

Colomba²,

Carlo³

et al. 2020

Cureus

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“…We received from the Spanish Ministry of Health the SNHDD including all patients with a primary (first position) or secondary diagnosis (positions 2 to 14) of IE (ICD-9-CM codes 421.0, 421.1, 421.9, 424.99) hospitalized from year 2001 to year 2015. These codes have been frequently used in previous studies of IE using hospital discharge databases [3, 4, 28, 33].…”

Section: Methodsmentioning

confidence: 99%

Infective endocarditis according to type 2 diabetes mellitus status: an observational study in Spain, 2001–2015

Miguel‐Yanes

Jiménez-García

Hernández-Barrera

et al. 2019

Cardiovasc Diabetol

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BackgroundThe main aims of this study were to describe trends and outcomes during admission for infective endocarditis (IE) in people ≥ 40 years old with or without type 2 diabetes distributed in five time-periods (2001–2003; 2004–2006; 2007–2009; 2010–2012 and 2013–2015), using Spanish national hospital discharge data.MethodsWe estimated admission rates by diabetes status. We analyzed comorbidity, therapeutic procedures, and outcomes. We built Poisson regression models to compare the adjusted time-trends in admission rates. Type 2 diabetes cases were matched with controls using propensity score matching (PSM). We tested in-hospital mortality (IHM) in logistic regression analyses.ResultsWe identified 16,626 hospitalizations in patients aged ≥ 40 years for IE in Spain, 2001–2015. The incidence of IE increased significantly from 6.0/100,000 per year to 13.1/100,000 per year (p < 0.001) in the population with type 2 diabetes, and from 3.9/100,000 per year to 5.5/100,000 per year (p < 0.001) in the population without diabetes, over the study period. The adjusted incidence of IE was 2.2-times higher among patients with diabetes than among those without diabetes (IRR = 2.2; 95% CI 2.1–2.3). People with type 2 diabetes less often underwent heart valve surgery than people without diabetes (13.9% vs. 17.3%; p < 0.001). Although IHM decreased significantly in both groups over time, it represented 20.8% of IE cases among diabetes patients and 19.9% among PSM matched controls (p = 0.337). Type 2 diabetes was not associated with a higher IHM in people admitted to the hospital for IE (OR = 1.1; 95% CI 0.9–1.2).ConclusionIncidence rates of IE in Spain, among those with and without T2DM, have increased during the period 2001–2015 with significantly higher incidence rates in the T2DM population. In our population based study and after PSM we found that T2DM was not a predictor of IHM in IE.

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“…Predictors of increased risk for re-admission included female sex, staphylococcus aureus infection, diabetes mellitus, chronic obstructive pulmonary disease, chronic liver disease, acute kidney injury, acute heart failure and anemia. In addition to above, the duration of admission was also a risk factor for readmission in the study by Morita et al (2019). The incidence of Staphylococcus aureus IE been steadily rising, and currently Staphylococcus aureus is the leading cause of acute IE (Tong et al, 2015).…”

Section: Discussionmentioning

confidence: 79%

“…They found an 18% mortality rate (95% confidence interval (CI): 14%-23%) one-year post-discharge and 65% (95% CI: 59%-71%) re-admission rate within the first year. Table 2 lists all the studies found in English literature describing the readmission rates for IE (Amodeo et al, 2009;Kashef et al, 2017;Morita et al, 2019;Rasmussen et al, 2017). The study by Morita et al, also a population based study reported a readmission rate of 24.8% in 2010-2014 NRD database (Morita et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…Table 2 lists all the studies found in English literature describing the readmission rates for IE (Amodeo et al, 2009;Kashef et al, 2017;Morita et al, 2019;Rasmussen et al, 2017). The study by Morita et al, also a population based study reported a readmission rate of 24.8% in 2010-2014 NRD database (Morita et al, 2019). The most common causes for readmission included infective endocarditis, other infectious causes, and cardiac causes.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of 30-day re-admissions in patients with infective endocarditis: a national population based cohort study

Agrawal

Virk

Riaz

et al. 2020

Rev. Cardiovasc. Med.

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Infective endocarditis (IE) is a life threatening disease requiring lengthy hospitalizations, complex multidisciplinary management and high health care costs. In this study, we analyzed the National Readmissions' Database (NRD) to identify infective endocarditis cases and the causative organisms, clinical determinants, length of stay, in-hospital mortality, and 30-day hospital readmission rates. The study cohort was derived from Healthcare Cost and Utilization Project's National Readmission Database between 2010-15. We queried the National Readmissions' Database using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic code for infective endocarditis (421.0) and identified a total of 187,438 index admissions. SAS 9.4 (SAS Institute Inc., Cary, NC) was utilized for statistical analyses. A total of 187,438 patients with a primary diagnosis of IE were identified over 6 years (2010-2015). Twenty-four percent (44,151 patients) were readmitted within 30 days. Most common etiologies for readmission included sepsis (14%), acute heart failure (8%), acute kidney injury (6%), intracardiac device infection (5.6%) and recurrence of IE (2.7%). Predictors of increased readmissions included female sex, staphylococcus aureus infection, diabetes, chronic lung disease, chronic liver disease, acute kidney injury, acute heart failure and anemia. Inhospital mortality for the readmission of IE was 13%, and average length of stay during the re-admission was 12 days. IE is associated with high rates of index admission mortality and for 30-day readmissions of which are associated with a substantial risk of death.

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Thirty‐Day Readmission After Infective Endocarditis: Analysis From a Nationwide Readmission Database

Cited by 31 publications

References 26 publications

Infective Endocarditis: Preliminary Results of a Cohort Study in the Southern Italian Population

Infective Endocarditis: Preliminary Results of a Cohort Study in the Southern Italian Population

Infective endocarditis according to type 2 diabetes mellitus status: an observational study in Spain, 2001–2015

Predictors of 30-day re-admissions in patients with infective endocarditis: a national population based cohort study

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