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Changing Trends in Demographics, Risk Factors, and Clinical Features of Patients With Infective Endocarditis-Related Stroke, 2005-2015.
Ridha, Mohamed; Flaherty, Mathew L; Aziz, Yasmin; Ades, Laura; Alwell, Kathleen; Khoury, Jane C; Woo, Daniel; Ferioli, Simona; Adeoye, Opeolu; Khatri, Pooja; De Los Rios La Rosa, Felipe; Mistry, Eva A; Demel, Stacie L; Mackey, Jason; Martini, Sharyl; Coleman, Elisheva; Jasne, Adam; Slavin, Sabreena; Walsh, Kyle; Star, Michael; Haverbusch, Mary; Madsen, Tracy E; Broderick, Joseph P; Kissela, Brett; Kleindorfer, Dawn O.
Afiliação
  • Ridha M; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Flaherty ML; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Aziz Y; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Ades L; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Alwell K; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Khoury JC; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Woo D; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Ferioli S; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Adeoye O; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Khatri P; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • De Los Rios La Rosa F; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Mistry EA; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Demel SL; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Mackey J; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Martini S; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Coleman E; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Jasne A; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Slavin S; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Walsh K; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Star M; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Haverbusch M; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Madsen TE; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Broderick JP; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Kissela B; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
  • Kleindorfer DO; From the Columbia University Medical Center (M.R.), New York; University of Cincinnati Medical Center (M.R., M.L.F., Y.A., L.A., K.A., D.W., S.F., P.K., E.A.M., S.L.D., K.W., M.H., J.P.B., B.K., D.O.K.), OH; NYU Langone Hospital at Brooklyn (L.A.); Cincinnati Children's Hospital Medical Center (J.C.
Neurology ; 100(15): e1555-e1564, 2023 04 11.
Article em En | MEDLINE | ID: mdl-36746635
ABSTRACT
BACKGROUND AND

OBJECTIVES:

There is a rising incidence of infective endocarditis-related stroke (IERS) in the United States attributed to the opioid epidemic. A contemporary epidemiologic description is necessary to understand the impact of the opioid epidemic on clinical characteristics of IERS. We describe and analyze trends in the demographics, risk factors, and clinical features of IERS.

METHODS:

This is a retrospective cohort study within a biracial population of 1.3 million in the Greater Cincinnati/Northern Kentucky region. All hospitalized patients with hemorrhagic or ischemic stroke were identified and physician verified from the 2005, 2010, and 2015 calendar years using ICD-9 and ICD-10 codes. IERS was defined as an acute stroke attributed to infective endocarditis meeting modified Duke Criteria for possible or definite endocarditis. Unadjusted comparison of demographics, risk factors, outcome, and clinical characteristics was performed between each study period for IERS and non-IERS. An adjusted model to compare trends used the Cochran-Armitage test for categorical variables and a general linear model or Kruskal-Wallis test for numerical variables. Examination for interaction of endocarditis status in trends was performed using a general linear or logistic model.

RESULTS:

A total of 54 patients with IERS and 8,204 without IERS were identified during the study periods. Between 2005 and 2015, there was a decline in rates of hypertension (91.7% vs 36.0%; p = 0.0005) and increased intravenous drug users (8.3% vs 44.0%; p = 0.02) in the IERS cohort. The remainder of the stroke population demonstrated a significant rise in hypertension, diabetes, atrial fibrillation, and perioperative stroke. Infective endocarditis status significantly interacted with the trend in hypertension prevalence (p = 0.001).

DISCUSSION:

From 2005 to 2015, IERS was increasingly associated with intravenous drug use and fewer risk factors, specifically hypertension. These trends likely reflect the demographics of the opioid epidemic, which has affected younger patients with fewer comorbidities.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Acidente Vascular Cerebral / Endocardite / Hipertensão Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans País/Região como assunto: America do norte Idioma: En Revista: Neurology Ano de publicação: 2023 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Acidente Vascular Cerebral / Endocardite / Hipertensão Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans País/Região como assunto: America do norte Idioma: En Revista: Neurology Ano de publicação: 2023 Tipo de documento: Article