Abstract 11467: Causative Organisms, Length of Stay, In-Hospital Mortality and Predictors of 30-Day Readmissions in Patients With Infective Endocarditis: A National Readmission Database Study.

Introduction: Infective endocarditis (IE) poses a great challenge to the field of cardiology due to high mortality, approaching 30% at 1-year, despite optimal care. Hypothesis: We studied causative organisms, in-hospital mortality and predictors of 30-day hospital readmission after a diagnosis of IE. Methods: Nationwide Readmissions Database was utilized to identify patients with a primary discharge diagnosis of IE using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9, CM), procedural code 421.0. Primary outcome was 30-day readmission. Hierarchical multivariable logistic regression was used to adjust for confounders. Results: Over 6 years (2010-2015), 187,438 patients were admitted with a primary diagnosis of IE. Twenty four percent were readmitted within 30 days. Staphylococcus aureus (27%), streptococcus viridians (22%), gram negative species (6%) and fungal species (0.24%) were identified as causative organisms. Predictors of increased readmissions were female sex (odds ratio [OR] 1.06, 95% confidence interval [CI] 1.02 to 1.1, p<0.001), staphylococcus aureus infection (OR 1.06, 95% CI 1.02 to 1.1, p <0.001), diabetes (OR 1.11, 95%CI 1.07 to 1.63, p<0.001), chronic lung disease (OR 1.16, 95%ci 1.11 TO 1.2, P<0.001), chronic liver disease (or 1.06, 95%CI 1.1 to 1.23, p<0.001), acute kidney injury (OR 1.32, 95%CI 1.26 to 1.37, p<0.001), acute heart failure (OR 1.17, 95%CI 1.12 to 1.22, p<0.001) and anemia (OR 1.09, 95%CI 1.06 to 1.13, p<0.01). In-hospital mortality was 13% and average length of stay (LOS) was 12 days. Thirty-six percent patients were discharged to a facility. Conclusions: We identified high in-hospital mortality and 30-day readmission rates for IE patients between 2010 and 2015. Females, staphylococcus aureus infection, anemia, acute heart failure, chronic lung disease, chronic liver disease, acute kidney injury and diabetes were independently associated with increased 30-day readmissions in IE patients. [ABSTRACT FROM AUTHOR]