Racial and ethnic disparities in the prevalence, outcomes, and management of infective endocarditis in the United States

Introduction Racial/ethnic differences in the prevalence, outcomes, and management of infective endocarditis (IE) remain unclear. Methods We assessed racial/ethnic differences in the prevalence, baseline characteristics, surgical intervention (valve replacement/repair), and clinical outcomes of hospitalizations for IE from 2016 to 2021 using the National Inpatient Sample (NIS). A multivariable regression model was used to adjust for potential confounders. Results A total of 78,600 hospitalizations for IE were identified, of which 76.7 % included White race, 10.7 % Black race, 7.7 % Hispanic ethnicity, and 4.9 % from other races/ethnicities. The median age was 51 (Interquartile Range [IQR] 34–67), and 41.1 % were female. Black race, Hispanic ethnicity, and other races/ethnicities were not associated with a significant difference in odds of receiving cardiac valve intervention when compared to White race. Black race (aOR 1.40; CI 1.08–1.80) was associated with higher odds of in-hospital mortality compared to White race. Black race, Hispanic ethnicity, and patients of other races/ethnicities were associated with higher odds of acute kidney injury requiring dialysis compared to White patients. Black race and patients of other races/ethnicities were associated with higher odds of cardiogenic shock when compared to White race. Black race was associated with lower odds of spleen infarction when compared to White patients. Conclusion Racial/ethnic disparities exist in the prevalence, outcomes, and management of patients hospitalized for IE in the US. Further studies are warranted to identify the reasons for such disparities and to guide policy initiatives to achieve equity.