Obesity as a Risk Factor Among Hospitalized Patients with Infective Endocarditis

OBJECTIVE: Obesity contributes to diagnostic and management challenges for many hospitalized patients. The impact of obesity on in-hospital outcomes in patients with infective endocarditis has not been studied and was the focus of this investigation. METHOD: We used the 2013 and 2014 Nationwide Inpatient Sample to identify adults ≥18 years of age with a principle diagnosis of endocarditis. We divided the sample into 2 groups based on presence of absence of obesity. Multivariate linear and logistic regression analysis was used to compare in-hospital mortality, valvular replacement, length of stay (LOS), and hospitalization charges. RESULTS: A total of 24 494 adults 18 years and older were hospitalized with infective endocarditis, of which 2625 were classified as obese. Patients with obesity were older (mean age, 57.8 ± 0.3 vs 54.3 ± 0.6 years; P < .01), more likely to be female (50.1% vs 36.1%; P < .01), and had more comorbidities (Charlson comorbidity score ≥ 3, 50.6% vs 28.8%; P < .01). Multivariate regression analysis found no differences between the 2 groups for mortality or repairs or replacements for any valve. On evaluation of resource utilization, patients with obesity had longer average LOS (13.9 days; confidence interval [CI], 12.7–15.1 vs 12.4 days; CI, 12.0–12.8; P = .016) and higher total hospital charges (US $160 789.90; CI, $140.922.40–$180 657.50 vs US $130 627.20; CI, $123 916.70–$137 337.70; P <.01). After adjustment for LOS for total hospital charges, there was no observed difference $11436.26 (CI, -$6649.07–$29521.6; P = .22). CONCLUSIONS: . Obesity does not significantly impact in-hospital mortality or surgical valvular interventions among patients hospitalized with infective endocarditis, but obesity is associated with increased utilization of hospital resources.