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Contributors to Hospitalized Infective Endocarditis Outcomes Among Patients With Substance Use.

Christine Kociszewski1,2, Christina J Ezemenaka3, Susan J Appel4

  • 1Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL, USA ckociszewski@gmail.com.

Journal of Doctoral Nursing Practice
|March 27, 2024
PubMed
Summary
This summary is machine-generated.

Patients with substance use (SU) and infective endocarditis (IE) often leave against medical advice (DAMA). Opioid and stimulant use, Medicaid, and shorter hospital stays were linked to DAMA, but not 30-day readmission.

Keywords:
discharge against medical adviceinfective endocarditisreadmissionsubstance use

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Addiction Medicine

Background:

  • Patients with substance use (SU) and infective endocarditis (IE) face high rates of discharge against medical advice (DAMA) and 30-day readmissions.
  • Understanding factors contributing to these adverse outcomes is crucial for improving patient care.

Purpose of the Study:

  • To identify demographic and clinical factors associated with DAMA and 30-day readmission in patients with SU and IE.
  • To inform targeted interventions for this vulnerable patient population.

Main Methods:

  • Retrospective chart review of patients over 18 years old admitted with SU and IE between January 2018 and December 2020.
  • Descriptive statistics and logistic regression analysis were used to evaluate associations with DAMA and 30-day readmission.

Main Results:

  • Of 144 patients, 38.2% experienced DAMA and 61.1% were readmitted within 30 days.
  • Factors significantly associated with DAMA included younger age, shorter length of stay, Medicaid insurance, opioid use, and stimulant use.
  • These factors were not significantly associated with 30-day readmission.

Conclusions:

  • Specific patient characteristics and substance use patterns are linked to DAMA in SU and IE patients.
  • Further research is needed to develop strategies to reduce DAMA and improve treatment adherence in this population.
  • Nursing interventions are vital for addressing the unique needs of SU IE patients to optimize treatment outcomes.