Abstract 15593: In Hospital Outcomes and Prevalence of Comorbidities in Patients With Infective Endocarditis With and Without Heart Blocks - Insight From a National Inpatient Sample

Abstract

Objective: To study inpatient outcomes of infective endocarditis (IE) with concurrent heart blocks Introduction: IE complicated with heart blocks can have adverse outcomes and usually requires immediate surgical and cardiac interventions. Data on outcomes and trends in patients with IE with concurrent heart blocks are lacking. Methods: Patients with a principle diagnosis of IE with or without heart blocks were identified by querying the Healthcare Cost and Utilization (HCUP) database, specifically, the National Inpatient Sample for year 2013 and 2014 based on ICD9 codes. Results: During 2013 and 2014, a total of 18,733 patients were admitted with a diagnosis of IE, out of whom 867 had concurrent heart blocks. There was an increased in-hospital mortality (13% vs 10.3%), length of stay (19 vs 14 days), cost of care (282,573 vs 223,559), cardiogenic shock (8.9% vs 3.2%), placement of an ICD/CRT/PPM (30.6% vs 0.9%), acute kidney injury (40.1% vs 32.6%) and hematologic complications (19.3 vs 15.2%) in patients admitted with IE with heart blocks as compared to those with IE but without heart block. Infective endocarditis and concurrent heart block resulted in increased requirement for aortic (25.7 vs 6.1%) and mitral (17.3% vs 4.2%) valvular replacements as compared to IE without heart block. Conclusions: IE with concurrent heart block worsens in-hospital mortality, length and cost of hospital stay. Our analysis clearly demonstrates an increase in the indications for cardiac procedures, specifically aortic and/or mitral valve replacements and ICD/CRT/PPM placement. A close tele monitoring system and prompt interventions may represent a significant mitigation strategy to avoid adverse outcomes observed in this study.