Division of Cardiology, Department of Internal Medicine, Emory University, Atlanta, GA 30322, USA.
Division of Cardiology, Department of Internal Medicine, Einstein Medical Center, Philadelphia, PA 19141, USA.
Rev Cardiovasc Med. 2020 Mar 30;21(1):123-127. doi: 10.31083/j.rcm.2020.01.552.
Infective endocarditis (IE) is a life threatening disease requiring lengthy hospitalizations, complex multidisciplinary management and high health care costs. In this study, we analyzed the National Readmissions' Database (NRD) to identify infective endocarditis cases and the causative organisms, clinical determinants, length of stay, in-hospital mortality, and 30-day hospital readmission rates. The study cohort was derived from Healthcare Cost and Utilization Project's National Readmission Database between 2010-15. We queried the National Readmissions' Database using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic code for infective endocarditis (421.0) and identified a total of 187,438 index admissions. SAS 9.4 (SAS Institute Inc., Cary, NC) was utilized for statistical analyses. A total of 187,438 patients with a primary diagnosis of IE were identified over 6 years (2010-2015). Twenty-four percent (44,151 patients) were readmitted within 30 days. Most common etiologies for readmission included sepsis (14%), acute heart failure (8%), acute kidney injury (6%), intracardiac device infection (5.6%) and recurrence of IE (2.7%). Predictors of increased readmissions included female sex, staphylococcus aureus infection, diabetes, chronic lung disease, chronic liver disease, acute kidney injury, acute heart failure and anemia. In-hospital mortality for the readmission of IE was 13%, and average length of stay during the re-admission was 12 days. IE is associated with high rates of index admission mortality and for 30-day readmissions of which are associated with a substantial risk of death.
感染性心内膜炎（IE）是一种危及生命的疾病，需要长时间住院治疗、复杂的多学科管理和高昂的医疗保健费用。在这项研究中，我们分析了国家再入院数据库（NRD），以确定感染性心内膜炎病例和病原体、临床决定因素、住院时间、住院死亡率以及 30 天内再入院率。研究队列来自医疗保健成本和利用项目的国家再入院数据库，时间为 2010-15 年。我们使用国际疾病分类，第九修订版，临床修正（ICD-9-CM）诊断代码 421.0 对感染性心内膜炎进行了全国再入院数据库查询，共确定了 187438 例索引入院。SAS 9.4（SAS Institute Inc.，Cary，NC）用于统计分析。在 6 年内（2010-2015 年）共确定了 187438 例原发性 IE 患者。24%（44151 例）在 30 天内再次入院。再入院最常见的病因包括败血症（14%）、急性心力衰竭（8%）、急性肾损伤（6%）、心内装置感染（5.6%）和 IE 复发（2.7%）。再入院增加的预测因素包括女性、金黄色葡萄球菌感染、糖尿病、慢性肺病、慢性肝病、急性肾损伤、急性心力衰竭和贫血。IE 再入院的住院死亡率为 13%，再入院期间的平均住院时间为 12 天。IE 与较高的指数入院死亡率相关，30 天内再入院与死亡风险显著相关。
