Infective endocarditis hospitalizations & outcomes in patients with end-stage kidney disease: a nationwide data-linkage study

Peter J. Gallacher, David A. McAllister, Nicholas L Mills, Nicholas L. Cruden, Anoop S. V. Shah, Neeraj Dhaun*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Objective We investigated clinical features, microbiology, and outcomes of incident infective endocarditis (IE) hospitalizations in patients with end-stage kidney disease (ESKD) requiring dialysis or kidney transplantation over 25 years. Methods We conducted a retrospective, population-based cohort study linking national datasets in Scotland. Between 01/01/1990 and 12/31/2014, patients hospitalized with IE and with a history of ESKD were identified from national inpatient records and linked to national hospitalization and mortality data. From 01/01/2008, individual IE hospitalizations were additionally linked to national microbiology data. Multivariable logistic regression, adjusting for patient demographics and comorbidities, evaluated the association between ESKD and all-cause death at one and three years. Results Of 7,638 incident IE hospitalizations between 1990 and 2014, 2.8% (216/7,638) occurred in 210 patients with ESKD and 97.2% (7,422/7,638) occurred in 7,303 patients without ESKD. Positive blood cultures were identified in 42% (950/2,267) of incident IE hospitalizations from 2008. Staphylococcus aureus was isolated in 25.9% (21/81) and 12.8% (280/2,186) of patients with and without ESKD, respectively (p=0.002). ESKD was associated with an increased odds of death at one (44.9% versus 31.4%; adjusted odds ratio [aOR] 2.47, 95% confidence interval [CI] 1.85 to 3.30, p<0.001) and three years (63.9% versus 42.8%; aOR 3.77, 95% CI 2.79 to 5.12, p<0.001). Conclusions IE is associated with a poor prognosis in patients with ESKD, especially in the long-term. Compared to patients without ESKD, patients with ESKD were twice as likely to die within one year, and three times as likely to die within three years of IE hospitalization.
Original languageEnglish
JournalJournal of the American Heart Association
DOIs
Publication statusPublished - 28 Sept 2021

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