Abstract
Introduction: Infective endocarditis (IE) is a critical condition that can lead to complications such as embolic stroke. This study aimed to compare the in-hospital outcomes between IE patients with and without embolic stroke. Methods: We conducted a retrospective analysis using the National Inpatient Sample database from 2016 to 2020. We identified admissions with a principal diagnosis of IE, with embolic stroke as a secondary diagnosis. In-hospital outcomes, including mortality, length of stay, and total charge, were analyzed after adjusting for patients' demographics, hospital characteristics, and chronic comorbidities, including heart failure, hypertension, diabetes, chronic kidney disease, smoking, and hyperlipidemia. Results: A total of 62,200 admissions with IE were identified, of which 4,460 (7.2%) developed embolic stroke, with females accounting for 38% of the cohort. Patients who developed embolic stroke had a significantly higher risk of mortality (OR: 2.4, 95% CI: 1.8-3.1, P=0.000), longer length of stay (18 days, Coefficient: 5.8, 95% CI: 4.6-7.0, P=0.000), and higher total charge (285,285, Coefficient: 121,586, 95% CI: 98,119-145,054, P=0.000). Conclusion: Our study found that IE patients who experienced embolic stroke had significantly worse outcomes, including higher mortality rates, prolonged length of stay, and increased financial burden. These findings emphasize the need for targeted interventions and close monitoring for this high-risk subgroup to improve patient outcomes and resource utilization.
Published Version
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