Background: Age is a risk factor for infective endocarditis, and almost half of diagnosed patients are age ≥60 years. Large national studies have not evaluated inpatient mortality and surgical valvular interventions between older White and Black patients hospitalized with infective endocarditis.
Methods: We used the Nationwide Inpatient Sample database to identify older adults ≥ 60 years with a principle diagnosis of infective endocarditis. Multivariate logistic regression was used to compare in-hospital mortality and valvular repairs/replacement between older Black and White patients.
Results: Of 10,390 adults, age ≥60 years hospitalized for infective endocarditis during 2013 and 2014, 7,356 were White and 1,089 Black. Blacks were younger (mean age: 70.5±0.5 vs. 73.5±0.2 years, p<0.01), lived in more zip codes with a median annual income <$39,000/yr. (40.4% vs 18.8%, p<0.01), and had higher co-morbidity burden (Charlson comorbidity score ≥ 3: 54.6% vs 40.7%, p<0.01). After multivariate adjustment, Blacks had higher odds for in-hospital mortality (Odds Ratio (OR) = 2.0, [Confidence Interval (CI) 1.1-3.8]; p=0.020), and lower odds for mitral valve repairs/replacements (OR = 0.53, CI: 0.29-0.99, p=0.049).
Conclusions: Blacks age ≥60 years hospitalized with infective endocarditis are less likely to undergo mitral valvular repairs/replacement and had higher in-hospital mortality compared to White patients.