Publication Date
12-1-2024
Journal
Annals of Thoracic Surgery Short Reports
DOI
10.1016/j.atssr.2024.06.002
PMID
39790590
PMCID
PMC11708589
PubMedCentral® Posted Date
6-20-2024
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Abstract
BACKGROUND: Rising rates of substance use (SU) have resulted in an increasing need for left-sided valve surgery for SU-associated infective endocarditis (SU-IE). We compared outcomes, readmissions, and costs between IE patients with and without SU-IE in a national cohort.
METHODS: Using the Nationwide Readmissions Database (2016-2018), we identified 10,098 patients with infective endocarditis (IE) who underwent isolated aortic or mitral valve replacement. Outcomes within the same calendar year as the index operation were compared between patients with and without SU-IE. Multivariable logistic regressions were used to identify factors associated with in-hospital mortality and 30-day and 90-day readmissions. Kaplan-Meier analysis and a Cox proportional hazards model were used to compare freedom from calendar-year readmission between the groups.
RESULTS: Of the 10,098 patients with IE, 2145 (21%) had SU-IE. Although patients with SU-IE were younger (38 years vs 60 years;
CONCLUSIONS: Despite their younger age and fewer comorbidities, patients who undergo valve surgery for SU-IE use more resources and more often have calendar-year readmissions than patients with IE but without SU. Strategies are needed to expedite discharge and prevent readmission in patients with SU-IE.
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