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"Among IE patients, being IVDU has associated with a longer LOS and a higher risk of prolonged hospital stay" Nodoushani et al (2022).

How IV drug use affects length of stay following infective endocarditis

Abstract:

Introduction: Intravenous drug use (IVDU) and associated infective endocarditis (IE) has been on the rise in the US since the beginning of the opioid epidemic. IVDU-IE has high morbidity and mortality, and treatment can be lengthy. We aim to quantify the association between IVDU and length of stay (LOS) in IE patients.

Methods: The National Inpatient Sample database was used to identify IE patients, which was then stratified into IVDU-IE and non-IVDU-IE groups. Weighted values of hospitalizations were used to generate national estimates. Multivariable linear and logistic regression analyses were applied to estimate the effects of IVDU on LOS.

Results: We identified 1,114,257 adult IE patients, among which 123,409 (11.1%) were IVDU-IE. Compared to non-IVDU-IE patients, IVDU-IE patients were younger, had fewer comorbidities, and had an overall longer LOS (median : 10 [5-20] versus 7 [4-13] d, P < 0.001), with a greater percentage of patients with a LOS longer than 30 d (13.7% versus 5.7%, P < 0.001). After adjusting for multiple demographic and clinical factors, IVDU was independently associated with a 1.25-d increase in LOS (beta-coefficient = 1.25, 95% confidence interval : 0.95-1.54, P < 0.001) and 35% higher odds of being hospitalized for more than 30 d (odds ratio = 1.35, 95% CI: 1.27-1.44, P < 0.001).

Conclusions: Among IE patients, being IVDU has associated with a longer LOS and a higher risk of prolonged hospital stay. Steps toward the prevention of IE in the IVDU population should be taken to avoid an undue burden on the healthcare system.


Reference:

Nodoushani AY, Wang Y, Datar Y, Mohnot J, Karlson KJ, Edwards NM, Yin K, Dobrilovic N. Association of Intravenous Drug Use and Length of Stay Following Infective Endocarditis. J Surg Res. 2022 Nov 1;282:239-245. doi: 10.1016/j.jss.2022.10.004. Epub ahead of print. PMID: 36332302.