Impact of Opioid Epidemic on Infective Endocarditis Outcomes in the United States: From the National Readmission Database
Section snippets
Methods
Our data were derived from the 2017 NRD, under the Healthcare Cost and Utilization Project, supported by the Agency for Healthcare Research and Quality. The NRD is one of the largest publicly available all-payer inpatient care databases in the United States. This database represents 49.3% of total United States hospitalizations and 51.2% of the total United States population. Further details related to the NRD and data extraction methodology are available online.12 Because the NRD is a
Results
We identified 40,413 admissions for IE from the NRD in 2017 (January to November). Approximately 5,558 patients (13.8%) were readmitted within 30 days of discharge. Overall, 5,393 patients (10.9%) died during index hospitalization for IE. Baseline characteristics, hospital charges, geographic distribution, and variations of patients at index admission are presented in Figure 2 and Table 1.
Patients who were readmitted were younger (55 ± 20 vs 61 ± 19 years, p <0.001), and 44.5% of patients
Discussion
Hospitalizations for IE in the United States have been increasing over the last decade, with a marked increase in IE because of IVDU.4,13 In this study, we demonstrate in an adjusted analysis that substance abuse with opioids, cocaine, or other agents, and viral infection associated with IVDU, were predictive of 30-day readmission in patients with IE as opposed to traditional cardiovascular risk factors such as hypertension, PVD, or DM. An increase in opioid use has resulted from both oral
Disclosures
The authors have no conflicts of interest to declare.
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Funding: none.
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