Abstract
Purpose :
Endogenous endophthalmitis (EE) is caused by hematogenous spread of bacteria from an infectious source such as infectious endocarditis (IE). In patients with IE, certain risk factors may increase likelihood of EE. The purpose of this study is to identify demographic variables and systemic comorbidities that may increase the risk of developing EE in a population of inpatients above the age of 50.
Methods :
A retrospective database study was conducted using the National Inpatient Sample (NIS) from 2002-2014. ICD-9-CM codes were used to identify patients over the age of 50 with IE and risk factors associated with the development of EE. Descriptive statistics were performed with chi-square analysis, and risk factors were analyzed with binary logistic regression. All analyses were performed using IBM SPSS v25 and significance level was a=0.05 unless stated otherwise. Variables with no cases among patients with EE were removed from the analysis.
Results :
Of the 767224 inpatients with a diagnosis of IE, 2248 had a diagnosis of EE (0.29%). Women comprised 39.1% of patients without concomitant EE but comprised 41.1% of those with EE (p=0.099). Most cases of EE occurred in the 65–89-year-old group (54.6%). The majority of patients with EE were White (68.8%), followed by Hispanic (12.7%) and Black (11.8%). On multivariate analysis, patients in the 65–89-year-old group had decreased risk of developing EE compared to the 51–64-year-old group (OR, 0.79). Hispanic (OR, 1.59) and Asian/Pacific Islander (OR, 1.69) patients had increased risk of developing EE when compared to White patients. Patients with congestive heart failure (OR, 0.77), arrhythmia (OR, 0.67), and a cardiac device (OR, 0.25) had decreased risk of developing EE. Patients with diabetes with chronic complications (OR, 1.57) and diabetic ketoacidosis (DKA; OR, 2.59) had increased risk of developing EE. EE patients had greater lengths of stay (17.04 vs. 13.09 days), total hospital charges ($134268.66 vs. $103341.64), and mortality rate (16.0% vs 12.0%) when compared those without (p<0.001).
Conclusions :
Hispanic and Asian/Pacific Islander IE patients had a higher risk of being diagnosed with EE compared to White patients. Congestive heart failure, arrhythmia, and having a cardiac device were associated with a decreased risk of developing EE. Diabetes with chronic complications and DKA conferred an increased risk of developing EE.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.