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Clinical and economic outcomes of infective endocarditis.
- Source :
- Infectious Diseases; 2015, Vol. 47 Issue 2, p80-87, 8p, 3 Charts, 2 Graphs
- Publication Year :
- 2015
-
Abstract
- Background: In France, the estimated annual incidence of infective endocarditis (IE) is 33.8 cases per million residents. Valvular surgery is frequently undergone. We report an epidemiological and economic study of IE for 2007 - 2009 in a French region, using the hospital discharge database (HDD). Methods: The population studied concerned all the patients living in Centre region, France, hospitalized for IE. We extracted hospital stay data for IE from the regional HDD, with a definition based on IE-related diagnosis codes. The predictive positive value (PPV) and sensitivity (Se) of the definition were 87.4% and 90%, respectively, according to the Duke criteria (definite IE frequency 74.4%). Hospitalization costs were estimated, taking into account the fi xed hospital charges of the diagnosis-related group (DRG) and supplementary charges due to intensive care unit (ICU) stay. Results: The analysis included 578 patients. The annual average incidence was 45.4 cases per million residents. Valvular surgery was performed in 19.4% of cases. The hospital mortality was 17.6%. Multivariate analysis identified as risk factors for mortality an age ≥ 70 years (odds ratio (OR) = 3.03, 95% confidence interval (CI) = 1.78 - 5.18), staphylococcal IE (OR = 3.3, 95% CI = 1.9 - 5.7), chronic renal insufficiency (OR = 2.04, 95% CI = 1.00 - 4.15), ischemic stroke (OR = 2.55, 95% CI = 1.19 - 5.47), and hemorrhagic stroke (OR = 5.7, 95% CI = 1.9 - 17.3). The average cost per episode was $20 103 (€ 15 281). Conclusions: We report a higher incidence of IE than described by the French national study of 2008. Valvular surgery was considerably less frequent than in the published data, whereas mortality was similar. IE generates substantial costs. [ABSTRACT FROM AUTHOR]
- Subjects :
- INFECTIVE endocarditis
HEART valve surgery
MEDICAL care costs
INTENSIVE care units
HOSPITAL admission & discharge
EPIDEMIOLOGY
GRAM-negative bacteria
THERAPEUTICS
CHI-squared test
CONFIDENCE intervals
FISHER exact test
LENGTH of stay in hospitals
RESEARCH methodology
MULTIVARIATE analysis
STATISTICAL sampling
T-test (Statistics)
LOGISTIC regression analysis
RELATIVE medical risk
PREDICTIVE tests
DATA analysis software
DESCRIPTIVE statistics
HOSPITAL mortality
ODDS ratio
MANN Whitney U Test
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 23744235
- Volume :
- 47
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 102109984
- Full Text :
- https://doi.org/10.3109/00365548.2014.968608