Objectives
This study aimed to investigate the demographic differences amongst patients diagnosed
with infective endocarditis (IE), predictors of adverse events, and the association
between clinical decision-making and adverse health outcomes amongst patients with
IE.
Design
A retrospective cross-sectional study was conducted using the New South Wales (NSW)
Admitted Patient Data Collection (APDC) from the Centre for Health Record Linkage
(CHeReL).
Participants
All patients (N=18,044) from 2001 to 2020 in New South Wales who received a diagnosis
of IE using ICD-10-AM diagnostic code 133.0 were included.
Methods
Categorical variables were compared using the chi-square test or Fisher’s exact test,
while the t-test was used for continuous variables. The association between clinical
decision-making and adverse health outcomes amongst patients with IE were examined
via generalised linear mixed models.
Results
Sex, age, birthplace and referral impacted clinical decision-making, in-hospital death
and severity of the disease. Women experienced a higher risk of death and fewer escalations
of care. Admission and mortality increased with age, with those aged 60 and above
responsible for 60.8% of hospitalisations. Despite octogenarians making up one-fifth
of admissions and having the worst mortality rate (15.1%), they experienced only one
in 10 intensive care (ICU) admissions. Overseas-born patients had fewer escalations
of care and experienced less severe disease if referred by a medical practitioner.
One out of 10 admissions that resulted in a hospital death were given non-emergency
status, and one in two ICU patients died in hospital.
Conclusions
Sex, age, place of birth, and clinical decision-making were important predictors of
severe disease and death in hospital, lending weight that health care clinical decisions
may adversely impact health outcomes for populations of interest.
Keywords
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Article info
Publication history
Published online: February 10, 2023
Accepted:
December 7,
2022
Received in revised form:
October 30,
2022
Received:
August 16,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
