In-hospital outcomes and prevalence of comorbidities in patients with ST-elevation myocardial infarction with and without infective endocarditis: insight from the National Inpatient Sample (2013-2014).
Michael Stanley AlbostaShakeel M JamalAsim KichlooFarah WaniBeth BaileyJagmeet SinghRonak SoniMichael AljadahMelissa BeshayBashar Al JayyousiNicholas HaddadKhalil KanjwalPublished in: Journal of investigative medicine : the official publication of the American Federation for Clinical Research (2020)
In patients with infective endocarditis (IE), ST-elevation myocardial infarction (STEMI) is an uncommon phenomenon. Due to limited data, we intend to evaluate the clinical outcomes in hospitalized patients with STEMI with and without underlying IE. Mortality and morbidity are exponentially worse in STEMI with concomitant IE when compared with without IE. Patients with primary diagnosis of STEMI with and without IE were identified by querying the Healthcare Cost and Utilization Project database of the National Inpatient Sample for the years 2013 and 2014 based on International Classification of Diseases, Ninth Revision codes. During 2013 and 2014, a total of 117,386 patients were admitted with the principle diagnosis of STEMI, out of whom 305 had comorbid IE. There was a significantly increased in-hospital mortality (27.5% vs 10.8%), length of stay (LOS) (14 days vs 5 days), acute kidney injury (AKI; 44.9% vs 18.7%), stroke (23.6% vs 3%), aortic valve replacement (9.5% vs 0.3%), mitral valve replacement (0.2%-5.2%), sepsis (50% vs 6%) and acute respiratory failure (36.7% vs 16.7%) in patients with STEMI with IE when compared with patients with STEMI and without comorbid IE. STEMI without IE had a higher number of angiographies (58.7% vs 25.9%) and percutaneous coronary interventions (50.7% vs 14.4%) during the hospital course when compared with STEMI with IE. In conclusions, hospitalized patients with STEMI with a concurrent diagnosis of IE are at higher risk of in-hospital mortality, increased LOS, AKI, stroke, valve replacements, and acute respiratory failure.
Keyphrases
- st elevation myocardial infarction
- percutaneous coronary intervention
- respiratory failure
- acute kidney injury
- st segment elevation myocardial infarction
- healthcare
- coronary artery disease
- mitral valve
- acute coronary syndrome
- aortic valve replacement
- extracorporeal membrane oxygenation
- atrial fibrillation
- mechanical ventilation
- mental health
- end stage renal disease
- aortic stenosis
- quality improvement
- ejection fraction
- squamous cell carcinoma
- palliative care
- risk factors
- transcatheter aortic valve implantation
- type diabetes
- chronic kidney disease
- left ventricular
- deep learning
- machine learning
- cardiovascular disease
- total knee arthroplasty
- transcatheter aortic valve replacement
- skeletal muscle
- emergency department
- acute respiratory distress syndrome
- minimally invasive
- left atrial
- health information
- subarachnoid hemorrhage
- aortic dissection
- big data
- insulin resistance
- rectal cancer