Pulmonary complications worsen infective endocarditis outcomes

Pulmonary complications are more likely to arise in patients with drug use-related infective endocarditis (DU-IE) and leads to worse outcomes, a recent study has found.

Drawing from the National Inpatient Sample, researchers compared outcomes between admitted IE patients with (n=6,680; median age 32 years, 48 percent men) and without (n=82,415; median age 66 years, 54 percent men) pulmonary complications. Analysis was also conducted in consideration of the 15,490 patients who had DU-IE.

The most common pulmonary complication detected was septic pulmonary embolism, present in 5,895 patients. This was followed distantly by empyema (n=845) and lung abscess (n=720). The likelihood of pulmonary complications was nearly three times as high in DU-IE patients (odds ratio [OR], 2.97, 95 percent confidence interval [CI], 2.50–3.45).

Other significant predictors of pulmonary complications included elective admission, acute transfer, age, and comorbidity status.

In turn, such complications increased the odds of inpatient mortality by nearly twice (OR, 1.81, 95 percent CI, 1.39–2.35). Similarly, pulmonary involvement lengthened hospital stay by about 7 days (change in estimate [CIE], 7.22 days, 95 percent CI, 6.11–8.32) and hospital charges by nearly USD 80,000 (CIE, USD 78.10 thousand, 95 percent CI, 57.44–99.57).

“Patients with DU-IE have a particularly high prevalence of pulmonary complications of IE and was the strongest predictor of pulmonary complications. Moreover, pulmonary complications had a greater impact on poor outcomes in DU-IE patients. Given the significant impact on outcomes we observed … future efforts will examine optimal management strategies for patients with IE with pulmonary complications,” the researchers said.