Socioeconomic disparities in In-hospital outcomes and readmission rates among patients hospitalized with infective endocarditis: A national analysis from the United States.

BACKGROUND

Contemporary data elucidates an association between adverse outcomes and low socioeconomic status (SES) in patients with cardiovascular related hospitalizations. Despite this, the impact of SES status on infective endocarditis (IE) outcomes remains unknown.

OBJECTIVES

To assess the impact of SES on hospitalized IE cases.

METHODS

We queried the Nationwide Readmission Database (2016-2020) to identify adult patients with IE and stratified them based on mean income quartiles (≤2 quartile vs. ≥3 quartiles). The primary outcome was in-hospital mortality. Secondary outcomes included 30-day and 90-day readmissions, sepsis, mechanical circulatory support (MCS) use, acute kidney injury (AKI), pacemaker and valve replacement interventions, length of stay (LOS), and total hospital charges. Multivariable regression models adjusted for confounders.

RESULTS

Among 41,175 IE hospitalizations, 24,581 (59.7 %) included patients with low income. Low income was associated with higher odds of in-hospital mortality (aOR 1.21, 95 % CI 1.04-1.41, p = 0.012), 30-day readmissions (aOR 1.09, 95 % CI 1.01-1.17, p = 0.021), 90-day readmissions (aOR 1.1, 95 % CI 1.02-1.19, p = 0.012), sepsis (aOR 1.11, 95 % CI 1.03-1.19, p = 0.008), MCS use (aOR 1.48, 95 % CI 1.04-2.09, p = 0.027) and lower odds of stroke (aOR 0.86, 95 % CI 0.78-0.96, p = 0.005) compared with high-income. No differences were observed in odds of AKI, valve replacement intervention, pacemaker use, mean LOS and total hospital charges between both income groups.

CONCLUSION

Among IE hospitalizations, lower income was associated with higher odds of in-hospital mortality and non-fatal adverse outcomes compared to higher income individuals.