Palicherla Anirudh, Torres Rosa, Walters Ryan W, Thandra Abhishek, Narmi Ann, Smer Aiman
Department of Medicine, Creighton University School of Medicine, Omaha, NE.
Department of Medicine, Creighton University School of Medicine, Omaha, NE.
Curr Probl Cardiol. 2023 Oct;48(10):101863. doi: 10.1016/j.cpcardiol.2023.101863. Epub 2023 Jun 8.
Over the last decade, hospitalizations for infective endocarditis (IE) have been steadily increasing, leading to a significant healthcare burden. Pericardial effusion (PCE) has been identified as a serious complication of IE, yet no significant association with mortality has been established. Our study aims to further analyze and understand the significance of PCE in patients with IE. We performed a retrospective analysis using the national inpatient sample database to identify all the hospital admissions with IE using ICD 10 codes and stratified them into 2 groups based on the presence of PCE. The outcomes of interest were inhospital mortality, inhospital complications, need for cardiac surgery, and length of stay. From 2015 Q4-2019, a total of 76,260 hospitalizations were included (weighted: 381,300), of which 2.7% included a PCE diagnosis. Hospitalizations with a PCE diagnosis included patients that were younger (51 vs 61, P < 0.001), as well as slightly more males (58.0% vs 55.2%, P = 0.011), and black patients (16.9% vs 12.9%, P < 0.001). PCE was associated with higher in-hospital death (12.7% vs 9.0%, P < 0.001), longer lengths of stay (12 days vs 7 days, P < 0.001), higher rates of cardiac surgery (22.4% vs 7.3%, P < 0.001). The rates of heart failure, heart block, renal failure, cardiogenic shock, and embolic stroke were higher on PCE group. We found that presence of PCE is associated with higher inhospital mortality, longer length of stay, and greater utilization of cardiac surgery, as well as presence of heart failure, heart block, cardiogenic shock, and embolic stroke.
在过去十年中，感染性心内膜炎（IE）的住院人数一直在稳步增加，导致了巨大的医疗负担。心包积液（PCE）已被确定为IE的一种严重并发症，但尚未发现其与死亡率有显著关联。我们的研究旨在进一步分析和了解PCE在IE患者中的意义。我们使用国家住院样本数据库进行了一项回顾性分析，通过国际疾病分类第10版（ICD 10）编码识别所有IE住院患者，并根据是否存在PCE将他们分为两组。感兴趣的结局包括住院死亡率、住院并发症、心脏手术需求和住院时间。从2015年第四季度到2019年，共纳入了76260例住院病例（加权后：381300例），其中2.7%的病例包括PCE诊断。有PCE诊断的住院患者更年轻（51岁对61岁，P<0.001），男性比例略高（58.0%对55.2%，P = 0.011），黑人患者比例也更高（16.9%对12.9%，P<0.001）。PCE与更高的住院死亡率（12.7%对9.0%，P<0.001）、更长的住院时间（12天对7天，P<0.001）、更高的心脏手术率（22.4%对7.3%，P<0.001）相关。PCE组的心力衰竭、心脏传导阻滞、肾衰竭、心源性休克和栓塞性中风发生率更高。我们发现，PCE的存在与更高的住院死亡率、更长的住院时间、更多地进行心脏手术以及心力衰竭、心脏传导阻滞、心源性休克和栓塞性中风的存在相关。
