Bell, Angela, and Adegboye, Oyelola A. (2023) The Epidemiology of Infective Endocarditis in New South Wales, Australia: A Retrospective Cross-Sectional Study From 2001 to 2020. Heart, Lung and Circulation, 32 (4). pp. 506-517.

PDF (Accepted Author Manuscript) - Accepted Version Restricted to Repository staff only until 10 February 2025.

Abstract

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 = 18044) 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 ten 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 ten 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 healthcare clinical decisions may adversely impact health outcomes for populations of interest.

Item ID:	77528
Item Type:	Article (Research - C1)
ISSN:	1444-2892
Copyright Information:	Published Version: © 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. Accepted Version: © 2022. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Date Deposited:	14 Feb 2023 01:42
FoR Codes:	42 HEALTH SCIENCES > 4202 Epidemiology > 420299 Epidemiology not elsewhere classified @ 30% 42 HEALTH SCIENCES > 4202 Epidemiology > 420210 Social epidemiology @ 30% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320211 Infectious diseases @ 40%
SEO Codes:	20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200599 Specific population health (excl. Indigenous health) not elsewhere classified @ 50% 20 HEALTH > 2002 Evaluation of health and support services > 200207 Social structure and health @ 50%
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