Brar Ajit, Garg Ayushi, Kohli Isha, Ravi Soumiya, Singh Carol, Sohal Aalam, Alkotob M Luay
Department of Internal Medicine, Hurley Medical Center, Flint, Michigan, USA.
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Clin Cardiol. 2025 Apr;48(4):e70130. doi: 10.1002/clc.70130.
Liver transplant (LT) recipients are immunocompromised and thus predisposed to various bacterial and fungal infections, including infective endocarditis (IE). The current paper aims to determine the prevalence, characteristics, and outcomes of IE in LT recipients.
The National Inpatient Sample (NIS) data from 2016 to 2020 was used to identify LT recipients. Patients were separated into two groups based on the presence of IE. Information was collected on patient demographics, hospital characteristics, infections, comorbidities, and outcomes. Multivariate logistic regression was performed to assess the impact of IE on outcomes after adjusting for confounding factors.
A total of 170 650 patients who underwent LT were identified using NIS data from 2016 to 2020, of which 0.003% had IE. IE group had higher odds of in-hospital mortality [aOR 2.2 (95% CI 1.07-4.78)], Shock [aOR 2.7 (95% CI 1.61-4.65)], ICU admission [aOR 2.40 (95% CI 1.4-4.2)], longer Length of Stay [adj. Coeff- 3.4 days (95% CI -0.89-5.9, p < 0.008)], and higher hospitalization charges (adj. coeff-$65271.52, 95% CI $14 825-$115 718) than LT without IE group.
Staphylococcus was present in 18.6% of IE in LT, followed by enterococcus (12.8%) and gram-negative bacteria (9.8%). Concomitant IE was associated with increased in-hospital death, ICU stay, and shock. The IE group was also associated with increased LOS and total charges compared to the LT without IE. Although the prevalence of IE is low in LT recipients, its presence portends worse outcomes.
肝移植（LT）受者免疫功能低下，因此易发生各种细菌和真菌感染，包括感染性心内膜炎（IE）。本文旨在确定LT受者中IE的患病率、特征和结局。
使用2016年至2020年的全国住院患者样本（NIS）数据来识别LT受者。根据是否存在IE将患者分为两组。收集了患者人口统计学、医院特征、感染、合并症和结局等信息。进行多因素逻辑回归以评估在调整混杂因素后IE对结局的影响。
利用2016年至2020年的NIS数据共识别出170650例接受LT的患者，其中0.003%患有IE。与无IE的LT组相比，IE组的院内死亡率[aOR 2.2（95%CI 1.07 - 4.78）]、休克[aOR 2.7（95%CI 1.61 - 4.65）]、入住重症监护病房（ICU）[aOR 2.40（95%CI 1.4 - 4.2）]的几率更高，住院时间更长[调整系数 - 3.4天（95%CI - 0.89 - 5.9，p < 0.008）]，住院费用更高（调整系数 - 65271.52美元，95%CI 14825美元 - 115718美元）。
LT中18.6%的IE病例中存在葡萄球菌，其次是肠球菌（12.8%）和革兰氏阴性菌（9.8%）。合并IE与院内死亡、ICU住院时间和休克增加相关。与无IE的LT组相比，IE组还与住院时间延长和总费用增加相关。尽管LT受者中IE的患病率较低，但其存在预示着更差的结局。
