Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016
Background There has been an increase in the prevalence of drug abuse (DA) in the national opioid epidemic. With increasing DA, there is an increased risk of infective endocarditis (IE). There are limited recent data evaluating national trends on the incidence and geographical distribution of DA‐IE....
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| Format: | Article |
| Language: | English |
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Wiley
2019-10-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.012969 |
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| author | Amer N. Kadri Bryan Wilner Adrian V. Hernandez Georges Nakhoul Johnny Chahine Brian Griffin Gosta Pettersson Richard Grimm Jose Navia Steven Gordon Samir R. Kapadia Serge C. Harb |
| author_facet | Amer N. Kadri Bryan Wilner Adrian V. Hernandez Georges Nakhoul Johnny Chahine Brian Griffin Gosta Pettersson Richard Grimm Jose Navia Steven Gordon Samir R. Kapadia Serge C. Harb |
| author_sort | Amer N. Kadri |
| collection | DOAJ |
| description | Background There has been an increase in the prevalence of drug abuse (DA) in the national opioid epidemic. With increasing DA, there is an increased risk of infective endocarditis (IE). There are limited recent data evaluating national trends on the incidence and geographical distribution of DA‐IE. We aim to investigate those numbers as well as the determinants of outcome in this patient population. Methods and Results Hospitalized patients with a primary or secondary diagnosis of IE based on the International Classification of Diseases, Ninth and Tenth Revisions (ICD‐9, ICD‐10) were included. We described the national and geographical trends in DA‐IE. We also compared DA‐IE patients’ characteristics and outcomes to those with IE, but without associated drug abuse (non‐DA‐IE) using Poisson regression models. Incidence of DA‐IE has nearly doubled between 2002 and 2016 All US regions were affected, and the Midwest had the highest increase in DA‐IE hospitalizations (annual percent change=4.9%). Patients with DA‐IE were younger, more commonly white males, poorer, had fewer comorbidities, and were more likely to have human immunodeficiency virus, hepatitis C, concomitant alcohol abuse, and liver disease. Their length of stay was longer (9 versus 7 days; P<0.001) and were more likely to undergo cardiac surgery (7.8% versus 6.2%; P<0.001), but their inpatient mortality was lower (6.4% versus 9.1%; P<0.001). Conclusions DA‐IE is rising at an alarming rate in the United States. All regions of the United States are affected, with the Midwest having the highest increase in rate. Young‐adult, poor, white males were the most affected. |
| format | Article |
| id | doaj-art-e219851cfe7940ac9572a24ea003d550 |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2019-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-e219851cfe7940ac9572a24ea003d5502025-08-20T03:08:27ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802019-10-0181910.1161/JAHA.119.012969Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016Amer N. Kadri0Bryan Wilner1Adrian V. Hernandez2Georges Nakhoul3Johnny Chahine4Brian Griffin5Gosta Pettersson6Richard Grimm7Jose Navia8Steven Gordon9Samir R. Kapadia10Serge C. Harb11Cleveland Clinic Foundation Cleveland OHCleveland Clinic Foundation Cleveland OHUniversity of Connecticut/Hartford Hospital Evidence‐Based Practice Center Hartford CTCleveland Clinic Foundation Cleveland OHCleveland Clinic Foundation Cleveland OHCleveland Clinic Foundation Cleveland OHCleveland Clinic Foundation Cleveland OHCleveland Clinic Foundation Cleveland OHCleveland Clinic Foundation Cleveland OHCleveland Clinic Foundation Cleveland OHCleveland Clinic Foundation Cleveland OHCleveland Clinic Foundation Cleveland OHBackground There has been an increase in the prevalence of drug abuse (DA) in the national opioid epidemic. With increasing DA, there is an increased risk of infective endocarditis (IE). There are limited recent data evaluating national trends on the incidence and geographical distribution of DA‐IE. We aim to investigate those numbers as well as the determinants of outcome in this patient population. Methods and Results Hospitalized patients with a primary or secondary diagnosis of IE based on the International Classification of Diseases, Ninth and Tenth Revisions (ICD‐9, ICD‐10) were included. We described the national and geographical trends in DA‐IE. We also compared DA‐IE patients’ characteristics and outcomes to those with IE, but without associated drug abuse (non‐DA‐IE) using Poisson regression models. Incidence of DA‐IE has nearly doubled between 2002 and 2016 All US regions were affected, and the Midwest had the highest increase in DA‐IE hospitalizations (annual percent change=4.9%). Patients with DA‐IE were younger, more commonly white males, poorer, had fewer comorbidities, and were more likely to have human immunodeficiency virus, hepatitis C, concomitant alcohol abuse, and liver disease. Their length of stay was longer (9 versus 7 days; P<0.001) and were more likely to undergo cardiac surgery (7.8% versus 6.2%; P<0.001), but their inpatient mortality was lower (6.4% versus 9.1%; P<0.001). Conclusions DA‐IE is rising at an alarming rate in the United States. All regions of the United States are affected, with the Midwest having the highest increase in rate. Young‐adult, poor, white males were the most affected.https://www.ahajournals.org/doi/10.1161/JAHA.119.012969drug abuseepidemiologyinfective endarteritismorbidity/mortality |
| spellingShingle | Amer N. Kadri Bryan Wilner Adrian V. Hernandez Georges Nakhoul Johnny Chahine Brian Griffin Gosta Pettersson Richard Grimm Jose Navia Steven Gordon Samir R. Kapadia Serge C. Harb Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease drug abuse epidemiology infective endarteritis morbidity/mortality |
| title | Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016 |
| title_full | Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016 |
| title_fullStr | Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016 |
| title_full_unstemmed | Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016 |
| title_short | Geographic Trends, Patient Characteristics, and Outcomes of Infective Endocarditis Associated With Drug Abuse in the United States From 2002 to 2016 |
| title_sort | geographic trends patient characteristics and outcomes of infective endocarditis associated with drug abuse in the united states from 2002 to 2016 |
| topic | drug abuse epidemiology infective endarteritis morbidity/mortality |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.012969 |
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