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

Eichenberger, Emily M; Dagher, Michael; Sinclair, Matthew R; Maskarinec, Stacey A; Fowler, Vance G; Federspiel, Jerome J

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

dc.contributor.author	Eichenberger, Emily M
dc.contributor.author	Dagher, Michael
dc.contributor.author	Sinclair, Matthew R
dc.contributor.author	Maskarinec, Stacey A
dc.contributor.author	Fowler, Vance G
dc.contributor.author	Federspiel, Jerome J
dc.date.accessioned	2022-02-01T19:58:51Z
dc.date.available	2022-02-01T19:58:51Z
dc.date.issued	2021-10
dc.date.updated	2022-02-01T19:58:50Z
dc.description.abstract	Background The epidemiology, and outcome of infective endocarditis (IE) among solid organ transplant (SOT) recipients is unknown. Methods 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. Results 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]). Conclusion Dual diagnosis of SOT and IE was associated with worse outcomes among SOT recipients during index hospitalization, but not overall among patients with IE.
dc.identifier	S0002-8703(21)00163-0
dc.identifier.issn	0002-8703
dc.identifier.issn	1097-6744
dc.identifier.uri	https://hdl.handle.net/10161/24326
dc.language	eng
dc.publisher	Elsevier BV
dc.relation.ispartof	American heart journal
dc.relation.isversionof	10.1016/j.ahj.2021.06.007
dc.subject	Humans
dc.subject	Endocarditis
dc.subject	Postoperative Complications
dc.subject	Treatment Outcome
dc.subject	Hospitalization
dc.subject	Length of Stay
dc.subject	Organ Transplantation
dc.subject	Hospital Mortality
dc.subject	Risk Factors
dc.subject	Regression Analysis
dc.subject	Retrospective Studies
dc.subject	Databases, Factual
dc.subject	Middle Aged
dc.subject	Hospital Costs
dc.subject	United States
dc.subject	Female
dc.subject	Male
dc.title	Infective endocarditis and solid organ transplantation: Only worse outcomes during initial transplantation hospitalization.
dc.type	Journal article
duke.contributor.orcid	Eichenberger, Emily M\|0000-0002-2469-0638
duke.contributor.orcid	Sinclair, Matthew R\|0000-0002-8003-9786
duke.contributor.orcid	Fowler, Vance G\|0000-0002-8048-0897
duke.contributor.orcid	Federspiel, Jerome J\|0000-0003-0321-6280
pubs.begin-page	63
pubs.end-page	72
pubs.organisational-group	Duke
pubs.organisational-group	School of Medicine
pubs.organisational-group	Staff
pubs.organisational-group	Basic Science Departments
pubs.organisational-group	Clinical Science Departments
pubs.organisational-group	Institutes and Centers
pubs.organisational-group	Molecular Genetics and Microbiology
pubs.organisational-group	Medicine
pubs.organisational-group	Obstetrics and Gynecology
pubs.organisational-group	Medicine, Infectious Diseases
pubs.organisational-group	Duke Clinical Research Institute
pubs.publication-status	Published
pubs.volume	240