Table 2.
Hospitalizations and Outcomes of Infective Endocarditis in Medicare Fee-for-Service Beneficiaries, 1999 to 2010.
| 1999 | 2000 | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Denominator (person-years) | 26,479,079 | 26,768,087 | 27,553,904 | 28,345,999 | 28,821,487 | 29,109,293 | 29,157,293 | 28,452,501 | 27,899,732 | 27,675,586 | 27,343,436 | 27,696,576 |
| Adjusted* endocarditis (principal or secondary diagnosis) hospitalization rate per 100,000 person-years | 72.0 | 73.4 (72-75.6) | 77.8 (75.6-79.2) | 79.2 (77.8-81.4) | 82.1 (79.9-84.2) | 83.5 (81.4-85.0) | 83.5 (82.1-85.7) | 82.1 (79.9-84.2) | 81.4 (79.9-83.5) | 79.2 (77-81.4) | 74.9 (72.7-76.3) | 70.6 (69.1-72.0) |
| Adjusted* endocarditis (principal diagnosis) hospitalization rate per 100,000 person-years Outcomes | 17.0 | 16.8 (16.2-17.5) | 16.0 (15.3-16.7) | 16.3 (15.6-17.0) | 16.8 (16.2-17.6) | 16.7 (16.0-17.3) | 15.5 (14.8-16.2) | 15.1 (14.5-15.8) | 13.9 (13.3-14.5) | 13.1 (12.6-13.8) | 12.2 (11.7-12.9) | 11.2 (10.7-11.7) |
| Length of stay (d) | 9.6 (11.5) | 9.3 (11.4) | 9.3 (11.0) | 9.3 (10.9) | 9.1 (10.5) | 8.8 (10.7) | 8.7 (10.4) | 8.5 ( 9.8) | 8.4 ( 9.2) | 8.7 (10.4) | 8.5 ( 9.9) | 8.4 ( 8.9) |
| In-hospital mortality (%) | 11.1 (10.6-11.5) | 10.6 (10.2-11.1) | 11.1 (10.7-11.5) | 11.4 (11.0-11.8) | 10.9 (10.5-11.3) | 10.3 (9.90-10.7) | 9.4 (9.0-9.8) | 9.0 (8.6-9.4) | 8.8 (8.4-9.2) | 9.7 (9.3-10.1) | 9.3 (8.9-9.7) | 9.1 (8.8-9.6) |
| Adjusted 30-day mortality (%)† | 15.8 (15.3-16.3) | 15.7 (15.0-16.5) | 16.1 (15.4-16.9) | 16.5 (15.8-17.2) | 16.1 (15.3-16.7) | 15.8 (15.1-16.6) | 15.0 (14.3-15.7) | 14.2 (13.5-14.9) | 14.6 (13.9-15.3) | 15.7 (15.0-16.3) | 15.1 (14.4-15.8) | 15.3 (14.6-16.1) |
| Adjusted 6-month mortality (%)† | 31.6 (30.9-32.2) | 31.4 (30.5-32.5) | 31.6 (30.7-32.7) | 31.8 (30.7-32.7) | 31.6 (30.7-32.7) | 31.2 (30.3-32.2) | 30.3 (29.4-31.4) | 28.4 (27.7-29.4) | 29.1 (28.2-30.1) | 30.3 (29.4-31.2) | 29.6 (28.5-30.5) | 29.6 (28.5-30.7) |
| Adjusted 1-year mortality (%)† | 35.7 (35.1-36.4) | 35.7 (34.8-36.6) | 36.2 (35.2-37.0) | 35.9 (35.0-36.8) | 35.5 (34.5-36.4) | 35.0 (34.1-36.2) | 33.8 (33.3-34.8) | 32.6 (31.5-33.3) | 33.1 (32.3-34.1) | 34.3 (33.3-35.2) | 33.3 (32.3-34.3) | 33.8 (32.8-34.8) |
| Discharge | ||||||||||||
| Disposition | ||||||||||||
| Home | 40.0 | 40.7 | 40.1 | 38.8 | 37.0 | 34.9 | 34.6 | 34.2 | 32.4 | 30.8 | 29.9 | 27.6 |
| Home health care | 11.7 | 11.3 | 11.3 | 11.5 | 12.4 | 14.4 | 14.3 | 15.2 | 16.1 | 15.5 | 16.2 | 16.7 |
| ICF/SNF | 26.0 | 25.8 | 25.0 | 25.1 | 24.7 | 25.5 | 26.2 | 26.1 | 26.2 | 26.6 | 26.9 | 28 |
| Hospice | 0.2 | 0.3 | 0.6 | 1.0 | 1.5 | 2.1 | 2.5 | 3.1 | 3.5 | 4.0 | 4.4 | 4.6 |
| Transferred out | 5.3 | 5.3 | 5.2 | 4.5 | 4.5 | 4.3 | 4.3 | 3.8 | 4.0 | 4.0 | 3.7 | 4.0 |
| Hospital death | 11.1 | 10.6 | 11.1 | 11.4 | 10.9 | 10.3 | 9.4 | 9.0 | 8.8 | 9.7 | 9.3 | 9.1 |
| Other‡ | 5.7 | 6.0 | 6.7 | 7.7 | 9.0 | 8.5 | 8.7 | 8.6 | 9.0 | 9.4 | 9.6 | 10.0 |
Numbers in parentheses reflect standard deviations for length of stay and 95% confidence intervals for hospitalization rates and outcomes.
*
Adjusted for age, sex, and race (reference: 1999)
†
Adjusted for age, sex, race, and clinical comorbidities (reference: 1999)
‡
Including discharge against medical advice
ICF/SNF, intermediate care facility/skilled nursing facility