Substance use disorder ups risk for death after IE valve surgery

(HealthDay)—Patients with infective endocarditis (IE) and substance use disorder (SUD) have a more than twofold risk for dying following valve surgery compared with patients without SUD, according to a study published online Oct. 16 in the Annals of Thoracic Surgery.

Alysse G. Wurcel, M.D., from Tufts Medical Center in Boston, and colleagues used data from the Society of Thoracic Surgeons Adult Cardiac Surgery Database to identify all valve surgeries for IE at Tufts Medical Center (2002 to 2016). Demographic and disease-related data were assessed. Deaths were confirmed through review of medical records and the Massachusetts Vital Statistics Database, with timing of mortality classified.

The researchers found that of 228 patients, 35 percent had SUD-related IE (SUD-IE). In total, 38 percent of patients died, but mortality was higher in people with SUD-IE versus those with non-SUD-IE (48 percent versus 32 percent). A higher risk for overall mortality was associated with SUD-IE (adjusted hazard ratio, 2.41). SUD-IE was associated with an increased frequency of midterm mortality (six months to five years), but there was no difference between short-term (less than six months) or extended-term (more than five years) mortality.

"Our data reflect high rates of postvalve surgery morbidity and mortality in people with SUD-IE at a tertiary care center," the authors write.

One author disclosed financial ties to Vertex Pharmaceuticals.

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