Shah-Khan Sardar M, Shah-Khan Sardar M, Alqahtani Fahad, Kupec Justin T
Department of Internal Medicine, West Virginia University School of Medicine/Ruby Memorial Hospital, Morgantown, USA.
Department of Gastroenterology and Hepatology, West Virginia University School of Medicine/Ruby Memorial Hospital, Morgantown, USA.
Cureus. 2020 Feb 8;12(2):e6919. doi: 10.7759/cureus.6919.
Introduction and aim Infective endocarditis (IE) cases are on the rise in the United States. The incidence of IE in patients with inflammatory bowel disease (IBD) has not been reported. Utilizing a national level database, we sought to estimate the incidence of IE in IBD-related hospitalizations and to determine its outcomes. Methods Discharge records from the National Inpatient Sample were analyzed, and the International Classification of Diseases, ninth revision, Clinical Modification codes (ICD-9-CM) was used to identify adult patients with IBD (Crohn's disease or ulcerative colitis) and IE between 2003 and 2014. Trends in the incidence of IE were recorded and multivariable regression was used to determine the impact of IE on IBD-hospitalizations. Results The incidence of IE in patients with IBD rose from 14.5 cases per 10,000 admissions in 2003 to 21.7 in 2014. After multivariable adjustment, both patient groups with CD (odds ratio [OR] 3.5, 95% confidence interval [CI] 3.0-4.1) and UC (OR 2.9, 95% CI 2.5-3.5) admitted with IE were found to be at greater risk for in-hospital mortality compared to non-IE admissions. Patients with IBD admitted with IE were found to have greater mean length of stay (13 days vs. six days, p<0.0001) and higher average hospital charges ($36,869.85 vs. $13,324.01, p <0.0001) compared to non-IE admissions. Conclusions Infective endocarditis is a growing complication in patients with IBD and is associated with increased mortality and utilization of healthcare resources. Further studies addressing the association between IE and IBD are needed.
引言与目的 在美国，感染性心内膜炎（IE）病例呈上升趋势。炎症性肠病（IBD）患者中IE的发病率尚未见报道。我们利用国家级数据库，旨在估算IBD相关住院患者中IE的发病率，并确定其预后情况。
方法 分析了国家住院患者样本的出院记录，并使用国际疾病分类第九版临床修订本编码（ICD-9-CM）来识别2003年至2014年间患有IBD（克罗恩病或溃疡性结肠炎）和IE的成年患者。记录IE发病率的趋势，并采用多变量回归分析来确定IE对IBD住院患者的影响。
结果 IBD患者中IE的发病率从2003年每10000例入院患者中的14.5例升至2014年的21.7例。经过多变量调整后，与非IE入院患者相比，因IE入院的克罗恩病（CD）患者组（比值比[OR] 3.5，95%置信区间[CI] 3.0 - 4.1）和溃疡性结肠炎（UC）患者组（OR 2.9，95% CI 2.5 - 3.5）的院内死亡风险更高。与非IE入院患者相比，因IE入院的IBD患者平均住院时间更长（13天对6天，p<0.0001），平均住院费用更高（36869.85美元对13324.01美元，p <0.0001）。
结论 感染性心内膜炎是IBD患者中日益增多的并发症，与死亡率增加及医疗资源利用增多相关。需要进一步研究IE与IBD之间的关联。
