Risk factors for endogenous endophthalmitis in infectious endocarditis patients.

Abstract

The purpose of this study was to identify demographic variables and systemic comorbidities that may increase risk of endogenous endophthalmitis (EE) development in patients with infective endocarditis (IE). A retrospective database study was conducted using the 2002-2014 National Inpatient Sample (NIS). Patients with IE and EE were identified using ICD-9-CM codes. Descriptive chi-square and logistic regression analysis identified risk factors for EE in IE patients. Of 769,472 inpatients with a diagnosis of IE, 2248 had a diagnosis of EE. Women comprised 39.7% of IE patients without EE and 42.6% of those with EE (p = 0.005). The majority of IE cases with EE were in those 21-64-year-old (58.5%) age cohort and 67.4% of cases were Whites. Multivariate analysis revealed IE patients in the 21-64 (OR, 3.660) and 65+ age group (OR, 2.852) had increased risk of developing EE compared to the 0-20-year-old group. Hispanic (OR, 1.377) and Asian/Pacific Islander (OR, 1.620) patients had increased risk compared to White patients. Diabetes with (OR, 2.043) and without (OR, 1.433) chronic complications, alcohol use disorder (AUD; OR, 1.795), and cirrhosis (OR, 1.452) conferred an increased risk of developing EE, whereas, congestive heart failure (CHF; OR, 0.716), arrhythmia (OR, 0.678), and having a cardiac device (OR, 0.336) decreased risk of EE in IE subjects. Older age (21+ years) and Hispanic and Asian/Pacific Islander background were associated with increased risk of developing EE in IE patients. Diabetes with and without chronic complications, AUD, or cirrhosis also conferred a 1.5-2 times increased risk. CHF, arrhythmia, or having a cardiac device were associated with decreased risk.