Abstract

Introduction: We aim to investigate the impact of heart failure (HF) among hospitalized patients with infective endocarditis (IE) in terms of in-hospital outcomes including the risk for mortality, development of cardiogenic shock (CS) and certain arrythmias, as well as hospital length of stay (LOS). Methods: We queried the 2018-2020 United States National Inpatient Sample (NIS) Database in conducting this retrospective cohort study. We identified hospitalized adult patients greater than 18 years of age with HF and IE using appropriate ICD-10 CM codes. Those with HF were subsequently stratified into systolic and diastolic HF. A survey multivariable logistic and linear regression analysis was used to calculate adjusted odds ratios (ORs) for the outcomes of interest. Results: A total of 150,059 hospitalized patients with IE were identified in the years 2018-2020, of which 33.58% (50,390/150,059) had HF. The overall in-hospital mortality rate among hospitalized patients with IE is 12.13% (18,185/150,059). Among those with HF, the in-hospital mortality rate was significantly higher at 15.11% (7,614/50,390, p<0.001). Using a stepwise survey multivariable logistic regression model that adjusted for patient and hospital level confounders, HF among hospitalized patients with IE increased the risk for adverse in-hospital outcomes. (Table 1) Conclusions: Our study showed that concomitant HF among hospitalized patients with IE increased the risk for in-hospital mortality, longer LOS, development of CS and certain arrythmias including atrial fibrillation, ventricular tachycardia, and ventricular fibrillation. This highlights the significant impact of HF as a potential predictor of worse outcomes among hospitalized IE patients.

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