Clinical outcomes in patients with native valve infective endocarditis and diabetes mellitus

Table 1 Baseline characteristics of primary hospitalizations for native valve infective endocarditis by diabetes mellitus in the United States from 2004–2014

Demographics and Co-morbidities	NVIE
	No DM (%)	DM (%)	P value
Age (yr), mean (SD)	58.2 ± 19	63.37 ± 14	< 0.0001
Gender			< 0.0001
Male	58.4	55.6
Female	41.6	44.4
Race			< 0.0001
White	71.9	62.5
Black	15.9	20.0
Hispanic	7.1	11.2
Asian	1.8	2.4
Native Americans	0.6	1.0
Other	2.7	2.9
Co-morbidities
Tobacco abuse	14.8	9.0	< 0.0001
Hypothyroidism	6.2	9.6	< 0.0001
Hyperlipidemia	11.5	25.1	< 0.0001
Valvular heart diseases	21.6	19.0	< 0.0001
Chronic kidney disease	3.8	7.9	< 0.0001
Obesity	1.8	7.2	< 0.0001
Congestive heart failure	26.2	34.2	< 0.0001
Chronic liver disease	9.3	12.4	< 0.0001
Hypertension	39.1	64.8	< 0.0001
HIV	2.6	0.9	< 0.0001
Atrial fibrillation	18.9	22.4	< 0.0001
Pulmonary hypertension	5.8	6.5	< 0.0001
Coronary artery disease	14.2	29.7	< 0.0001
Peripheral artery disease	2.4	5.5	< 0.0001
Hemodialysis	15.0	27.8	< 0.0001
History of cardiac arrest	0.0	0.1	0.011
History of drug abuse	11.9	3.8	< 0.0001
Congenital heart disease	1.8	0.8	< 0.0001
Rheumatic heart disease	11.8	9.6	< 0.0001

DM: Diabetes mellitus; HIV: Human immunodeficiency virus; SD: Standard deviation; NVIE: Native valve infective endocarditis.

Table 2 Infective organisms identified in primary hospitalizations for native valve infective endocarditis by diabetes mellitus in the United States from 2004–2014

Infective organisms	NVIE
	No DM (%)	DM (%)	P value
Staphylococcus aureus	33.1	35.6	< 0.001
Other staphylococcus	5.4	6.7	< 0.001
Viridans streptococci	18.6	15.5	< 0.001
Enterococci	6.5	7.6	< 0.001
Pneumococcus	0.5	0.4	0.11
Group A streptococci	0.7	0.5	0.003
Group B streptococci	1.3	1.6	< 0.001
Group C streptococci	0.1	0.1	0.44
Group G streptococci	0.2	0.2	0.87
Gram negative	3.8	4.8	< 0.001
Anaerobes	0.4	0.3	0.82
Fungemia	0.2	0.2	0.81

DM: Diabetes mellitus; NVIE: Native valve infective endocarditis.

Table 3 Inpatient procedures in primary hospitalizations for native valve infective endocarditis by diabetes mellitus in the United States from 2004–2014

NVIE
Inpatient procedures	No DM (%)	DM (%)	P value
Surgical valve replacement	12.3	9.2	< 0.001
Aortic valve replacement	6.5	5.1	< 0.001
Mitral valve replacement	5.0	3.7	< 0.001
Tricuspid valve replacement	0.1	0.1	0.43
Pulmonary valve replacement	0.7	0.3	< 0.001

Surgical valve replacement, included aortic valve replacement, mitral valve replacement, tricuspid valve replacement and pulmonary valve replacement. DM: Diabetes mellitus; NVIE: Native valve infective endocarditis.

Table 4 Association between diabetes mellitus and outcomes of hospitalizations for native valve infective endocarditis after propensity matching

NVIE
	No DM (%)	DM (%)	aOR	Lower CI	Upper CI	P value
In-hospital mortality	11.1	11.9	1.2	1.1	1.4	< 0.0001
Acute heart failure	4.6	6.5	1.2	1.1	1.3	0.001
Stroke	2.3	3.0	1.3	1.1	1.5	< 0.0001
Atrioventricular block	1.5	2.4	1.5	1.3	1.5	< 0.0001
Septic shock	7.2	9.6	1.2	1.1	1.3	< 0.0001
Cardiogenic shock	1.5	1.9	1.4	1.2	1.6	< 0.0001

aOR: Adjusted odds ratio; CI: Confidence interval; DM: Diabetes mellitus; NVIE: Native valve infective endocarditis.

Table 5 Logistic regression analysis for predictors of in hospital mortality among patients with native valve infective endocarditis and diabetes mellitus

	95%CI
	OR	Lower	Upper	P value
Age (yr)
18-65	REF	REF	REF	REF
> 65	1.02	1.02	1.02	< 0.001
Hypertension	0.56	0.50	0.62	< 0.0001
Atrial fibrillation	1.17	1.05	1.31	0.006
Tobacco abuse	0.74	0.61	0.90	0.003
Hyperlipidemia	0.69	0.61	0.78	< 0.0001
Congestive heart failure	1.34	1.22	1.48	< 0.0001
Chronic liver disease	1.51	1.19	1.92	0.001
Staphylococcus aureus	1.25	1.13	1.39	< 0.0001
Hemodialysis	2.04	1.83	2.27	< 0.0001

CI: Confidence interval; OR: Odds ratio; REF: Reference.