Author + information
- Prakrity Urja,
- Arjun Theertham,
- Mukund Kumar,
- Nina Zook,
- Kellen O'Neill,
- Ryan Walters,
- Ram Belbase,
- Renuga Vivekanandan and
- Venkata Alla
Background: Staphylococcus aureus bacteremia (SAB) carries significant morbidity and is one of the common causes of mortality in United States of America. Infective endocarditis (IE) occurs in approximately 10-30% of those with SAB. Thus, the ACC/AHA guidelines recommend transthoracic echocardiogram (TTE) in all cases with SAB and transesophageal echocardiogram (TEE) in those at high risk. In this study, we explored the national trends in the usage of echocardiography in patients admitted with SAB/septicemia.
Methods: We searched the National Inpatient Sample (NIS) database from 2001 through 2012 using ICD 9 codes (38.10. 38.11, 38.12) for eligible patients with a principle discharge diagnosis of Staphylococcus aureus septicemia or septic shock. Use of echocardiography was identified using procedure code 88.72. Logistic regression models was estimated to identify the year-over-year trend in Echocardiogram use, predictors of Echocardiogram use, and whether Echocardiogram use was independently associated with mortality. SAS v. 9.4 was used for all analyses; p < .05 was used to indicate statistical significance. Analyses for all outcomes accounted for NIS sampling design.
Results: There were 2,585,815 total patients with Staphylococcus aureus + sepsis (n=2,482,706), Staphylococcus aureus + septic shock (n=1,968), or Staphylococcus aureus + cardiac device (n=101,141). When considering all 2,585,815 patients, an increasing linear trend in rate of echocardiogram use was observed (10.0% to 13.9%, p < .001). After adjusting for risk factors, compared to patients who did not have Echocardiogram, Staphylococcus aureus + sepsis patients who received Echocardiogram had 30% decreased odds of dying (p < .001).
Conclusions: Use of Echocardiogram in SAB is increasing but still remains very low at 13.9%. Decrease in mortality by 30% in the population with SAB receiving Echocardiogram emphasizes the need of guideline directed use of Echocardiogram in patients admitted with SAB.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Insights From Echocardiography Use
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1291-231
- 2017 American College of Cardiology Foundation