Short Term Outcomes and Resource Utilization in Patients Admitted for Infective Endocarditis Who Develop Pericardial Effusion: A Retrospective Cohort Study.

Background: Pericardial effusion (PCE) development in the context of infective endocarditis (IE) may negatively impact clinical outcomes leading to intense resource utilization. Limited contemporary studies exist that examine clinical outcomes, resource utilization and readmission rates in patients admitted for IE who develop PCE. Methods: We utilized the Nationwide Readmissions Database years 2016-2022 to tabulate all adult admissions for IE. We compared clinical outcomes in patients who developed PCE to those who did not. Survey weighted logistic and linear regression analysis was performed to predict in-hospital mortality, clinical outcomes, costs, and 30-day non-elective readmission in association with PCE. Results: Of an estimated 162,694 total patients with IE, 2859 (1.8 %) had PCE and 159,835 (98.2 %) did not. Following risk adjustment, PCE was associated with higher odds of in-hospital mortality, acute heart failure, cardiogenic shock, acute kidney injury, and need for temporary mechanical circulatory support. Additionally, PCE was associated with longer duration of hospital stay and hospitalization costs. Interestingly, PCE cohorts who received drainage during index admission had lower odds of 30-day non-elective readmission. Conclusion: PCE after IE admission was linked with inferior outcomes including in-hospital mortality, and several other outcomes, as well as longer hospital stay and accrued costs. Notably, 30-day non-elective readmission was lower among patients with PCE who underwent intervention to drain the effusion during index hospitalization.