Infective endocarditis and solid organ transplantation: Only worse outcomes during initial transplantation hospitalization.



The epidemiology, and outcome of infective endocarditis (IE) among solid organ transplant (SOT) recipients is unknown.


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.


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]).


Dual diagnosis of SOT and IE was associated with worse outcomes among SOT recipients during index hospitalization, but not overall among patients with IE.





Published Version (Please cite this version)


Publication Info

Eichenberger, Emily M, Michael Dagher, Matthew R Sinclair, Stacey A Maskarinec, Vance G Fowler and Jerome J Federspiel (2021). Infective endocarditis and solid organ transplantation: Only worse outcomes during initial transplantation hospitalization. American heart journal, 240. pp. 63–72. 10.1016/j.ahj.2021.06.007 Retrieved from

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Matthew Sinclair

Assistant Professor of Medicine

Stacey Ann Maskarinec

Assistant Professor of Medicine

Jerome Jeffrey Federspiel

Assistant Professor of Obstetrics and Gynecology

Dr. Federspiel is a maternal fetal medicine physician at Duke University. His clinical and research interests focus on the care of people with cardiovascular and hematologic complications of pregnancy.

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