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Patients with infectious endocarditis (IE) and subarachnoid hemorrhage (SAH) had an increased risk of mortality from acute ischemic stroke (AIS).
New York Medical College researchers obtained data from the National Inpatient Sample, the Agency for Research and Quality in Healthcare, and the Healthcare Cost and Usage Project for this study. Patients (N = 82,844) with IE who were hospitalized between 2010 and 2015 were screened for clinical outcomes and mortality based on SAH status.
Only a few patients with IE had SAH at the same time (n = 641). The patients with IE and SAH were associated with a more complicated disease course and poorer outcomes, including an increased risk of mortality (odds ratio) [OR]4.65; 95% CI, 3.9-5.5; P <0.001).
Endovascular therapy for a mycotic aneurysm was performed in 3.6% (n = 23) of patients with SAH.
SAH was at an increased risk of ventriculitis (OR 7.1; 95% CI 4.2-11.9; P <0.001) and AIS (OR 6.3; 95% CI 5.4-7.4; P < 0.001) connected.
The AIS rate was 41.5% (n = 266) in patients with SAH, which was significantly higher than in patients without SAH (10.1%; n = 8267). Mechanical thrombectomy was required in 0.8% of all patients with AIS and 1.9% of patients with AIS and SAH comorbidities (P = 0.05).
Patients with IE and SAH were more likely to undergo endovascular therapy or mechanical thrombectomy, had a mycotic aneurysm or ventriculitis. Ultimately, the study researchers concluded that patients with IE “are at risk for numerous complications” and that patients with IE and concomitant SAH had “a significant increase in mortality and risk from AIS” compared to patients without SAH.
Disclosure: One author stated links to the pharmaceutical industry. For a full list of details, see the original article.
Sursal T., Karimov Z., Nazarenko A. et al. Significant increase in mortality and risk of acute ischemic stroke in patients with infectious endocarditis with subarachnoid hemorrhage