Infective endocarditis increases more than tenfold in North Carolina

December 5, 2018, University of North Carolina at Chapel Hill School of Medicine
Credit: CC0 Public Domain

The number of hospitalizations and surgeries to treat drug-associated infective endocarditis have both increased more than tenfold in North Carolina, according to doctors at the University of North Carolina School of Medicine who published their research in the Annals of Internal Medicine.

Endocarditis is an infection of one or more . Usually, this condition is seen in with damaged heart valves. Yet, bacteria introduced into the body through injection can also cause endocarditis, a phenomenon doctors around the state are seeing in startling rates.

"Drug use-associated infective endocarditis is markedly increasing across North Carolina," said Asher Schranz, MD, the study's author and a fellow in the UNC Division of Infectious Diseases. "It causes severe illness, and treatment is expensive. This condition has been somewhat overlooked, but it is a significant emerging concern that needs appropriate attention."

In collaboration with colleagues at Duke University and the N.C. Division of Public Health, Schranz studied state data on endocarditis hospitalizations from 2007 to 2017. They found a tenfold increase in the number of hospitalizations and heart valve surgeries for use-associated infective endocarditis, with the most significant spike in the past four years. As recently as mid-2013, less than 10 heart valve replacement surgeries were done to treat drug use-associated endocarditis. In the most recent year examined, mid-2016 to mid-2017, 109 surgeries were done in North Carolina to treat drug use-associated endocarditis and they overwhelmingly occurred in young people. The median age of patients undergoing surgery for this condition was 33.

These surgeries come with an expensive price tag. The median hospital charge for the entire hospitalization with valve replacement surgery was $251,000. More than 280 drug-associated endocarditis valve replacement surgeries were performed in North Carolina over the past 10 years, totaling about $78 million.

"We found that 73 percent of patients with drug use-associated infective endocarditis were uninsured or on Medicaid," Schranz said. "This means the costs of the surgery and hospitalization are absorbed by patients, individual hospitals, and government budgets, which finance Medicaid."

The increase in the number of hospitalizations and surgeries for drug use-associated infective endocarditis, as well as the burden the high cost of treatment has on hospitals and Medicaid, are the key takeaways from Schranz and his colleagues' research. They would like future studies to focus on the long-term outcomes of valve replacement , including reinfection, repeat surgeries, and drug overdose. The team would also like to explore ways to enhance delivery of addiction care services to patients while they are in the hospital and after discharge.

"Drug use-associated is a severe aspect of the opioid epidemic impacting North Carolina and likely many other states," Schranz said. "Our findings add to the urgency to enhance the resources for addressing , which can include improving access to the medications to treat opioid use disorder and linking patients to harm reduction services."

Explore further: Infective endocarditis increases tenfold in North Carolina

More information: Asher J. Schranz et al. Trends in Drug Use–Associated Infective Endocarditis and Heart Valve Surgery, 2007 to 2017, Annals of Internal Medicine (2018). DOI: 10.7326/M18-2124

Related Stories

Infective endocarditis increases tenfold in North Carolina

October 9, 2018
The number of hospitalizations and the number of surgeries to treat drug-associated infective endocarditis have both increased over tenfold in North Carolina, according to researchers at the University of North Carolina at ...

Risk factors and clinical outcomes of infective endocarditis after transcatheter aortic valve replacement

September 13, 2016
Among patients undergoing transcatheter aortic valve replacement, younger age, male sex, history of diabetes mellitus, and moderate to severe residual aortic regurgitation were significantly associated with an increased risk ...

Several invasive procedures linked to infective endocarditis

August 1, 2018
(HealthDay)—Several invasive medical procedures, including cardiovascular procedures and procedures of the skin and management of wounds, are associated with increased risk of infective endocarditis, according to a study ...

Infection of the heart valves and healthcare costs on rise due to impact of IV drug

April 26, 2018
A new study finds the number of patients hospitalized with endocarditis has increased dramatically over the last decade in a pattern that mirrors the increase in mixed drug use. The nearly decade-long retrospective study ...

Study finds heart infections increasing among younger injection drug users

September 1, 2016
Serious heart infections caused by injection drug use are on the rise, particularly among young whites, according to a new study published in Open Forum Infectious Diseases, now available online. Based on an analysis of health ...

Heart surgery, counselling may reduce infection-related deaths among drug users

November 22, 2018
In London, 55 per cent of people who experience heart-valve infections are injection drug users. They are particularly vulnerable to the disease and on-third of them die as a result of this infection.

Recommended for you

Study reveals new link between atrial fibrillation and mutations in heart disease gene

December 11, 2018
Atrial fibrillation (Afib), a heart condition that causes a rapid, irregular heartbeat that increases a person's risk of stroke and heart failure, is fairly common among older adults. However, its early onset form is relatively ...

Macrophage cells key to helping heart repair—and potentially regenerate, new study finds

December 11, 2018
Scientists at the Peter Munk Cardiac Centre have identified the type of cell key to helping the heart repair and potentially regenerate following a heart attack.

Possible connection between cardiovascular disease and living near oil and gas wells

December 11, 2018
Researchers at the Colorado School of Public Health have found a possible connection between the intensity of oil and gas exploration in an area and early indicators of cardiovascular disease among nearby residents.

Researchers have found that incidence of heart failure was around two-fold higher in people with diabetes

December 11, 2018
Researchers have found that incidence of heart failure was around two-fold higher in people with diabetes.

Effect of oral alfacalcidol on clinical outcomes in patients without secondary hyperparathyroidism

December 11, 2018
Treatment with active vitamin D did not decrease cardiovascular events in kidney patients undergoing hemodialysis, according to a research group in Japan. They have reported their research results in the December 11 issue ...

Study: Age, race differences determine risk of stroke in women and men

December 11, 2018
A new study found that, between the ages of 45 and 74 years, white women were less likely to have a stroke than white men, but at age 75 and older, there was no difference in stroke risk between white women and men. In contrast, ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.