A Single-Centre Canadian Cost Analysis for the Care and Management of Injection Drug Use-Associated Infective Endocarditis Requiring Cardiac Surgery.

Background: No Canadian data are available on the economic impact of cardiac surgery hospitalizations for injection drug use-related infective endocarditis (IDU-IE) during the current opioid crisis. This study aimed to quantify the healthcare system cost of care for patients with IDU-IE who required cardiac surgery in Calgary, Alberta, Canada. Methods: A retrospective cohort analysis of the cost of care for patients diagnosed with IDU-IE who had cardiac surgery between 2013 and 2019 was performed. The overall and categorical costs to the Canadian healthcare system for this specific population were quantified using the Alberta Health Services patient coding system and the Alberta Financial General Ledger. Results: Eighteen patients were diagnosed with IDU-IE and had cardiac surgery. The majority of patients underwent isolated tricuspid valve surgery. The mean postoperative intensive care unit and total hospital stays were 5.2 days and 24.9 days, respectively. No 30-day or in-hospital mortalities occurred. The average cost per patient from diagnosis to discharge was CAD$131,072 ± $17,844. The average cost of surgical intervention and postoperative course was CAD$63,090 ± $7983. The highest cost contributor was the cost of in-hospital nursing care. Conclusions: Patients diagnosed with IDU-IE who have cardiac surgery have higher per-patient cost than the general cardiac surgery population, as shown by comparison to other available data. This specific patient population has unique care needs that should be optimized to improve patient outcomes and improve healthcare resource utilization.