Abstract 12736: Prevalence, Characteristics, and Outcomes of Infective Endocarditis in Patients With Liver Disease in the United States

Introduction: Infective endocarditis (IE) is common in patients with liver disease. Data regarding IE in liver disease are limited.

Hypothesis: We analyzed IE admissions to determine inpatient outcomes among patients with liver disease in the United States.

Methods: We used the 2017 National Readmission Database to identify index admission of adults with IE, based on the International Classification of Disease, 10th revision codes. The primary outcome was 30-day readmission. Secondary outcomes were mortality and predictors of hospitalization readmission.

Results: We identified 40,413 IE admissions. Figure 1 presents prevalence of variables associated with liver disease in this cohort. Patients who were readmitted were more likely to have a history of hepatitis C virus (19.4% vs 12.3%, p < 0.001), hyponatremia (25% vs 21%, p < 0.001), and thrombocytopenia (20.3% vs 16.3%, p <0.001). After adjusting for age, hypertension, heart failure, diabetes mellitus, and end stage renal disease, hyponatremia (odds ratio (OR): 1.25; 95% confidence intervals [CI]: 1.17 to 1.35; p < 0.001) and thrombocytopenia (OR: 1.16; 95% CI: 1.08 to 1.24; p < 0.001) correlated with higher odds of 30-day readmission. Mortality was higher among patients with hyponatremia (29% vs 22%, p < 0.001), thrombocytopenia (29% vs 17%, p < 0.001), coagulopathy (12% vs 5%, p < 0.001), cirrhosis (6% vs 4%, p < 0.001), ascites (7% vs 3%, p <0.001), liver failure (18% vs 3%, p < 0.001), and portal hypertension (3% vs 1.5%, p < 0.001) (Figure 2).

Conclusions: Important liver disease related variables correlate with higher risks of hospital readmission and mortality in patients with IE. Targeting such variables may improve outcomes in this patient population.