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Reading: Nursing Home Admission and Initiation of Domiciliary Care Following Infective Endocarditis

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Original Research

Nursing Home Admission and Initiation of Domiciliary Care Following Infective Endocarditis

Authors:

Eva Havers-Borgersen ,

Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DK
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Emil L. Fosbøl,

Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DK
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Rasmus Rørth,

Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DK
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Kristian Kragholm,

Department of Cardiology and Clinical Epidemiology, Aalborg University Hospital, Aalborg, DK
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Søren L. Kristensen,

Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DK
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Henning Bundgaard,

Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DK
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Niels Eske Bruun,

Department of Cardiology, Roskilde University Hospital, Roskilde; Clinical Institute, Copenhagen University, Copenhagen; Clinical Institute, Aalborg University, Aalborg, DK
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Lauge Østergaard,

Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DK
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Mohsin Aslam,

Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DK
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Nana Valeur,

Department of Cardiology, Bispebjerg Hospital, Copenhagen, DK
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Gunnar H. Gislason,

Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, DK
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Christian Torp-Pedersen,

Department of Cardiology and Clinical Epidemiology, Aalborg University Hospital, Aalborg, DK
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Lars Køber,

Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DK
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Jawad H. Butt

Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DK
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Abstract

Background: Infective endocarditis (IE) may cause debilitating physical and mental changes that can interfere with activities of daily living. Admission to a nursing home and need for domiciliary care following hospitalization for IE represent such relevant outcomes, yet no such data have been reported.

Methods: Using Danish nationwide registries, we identified all patients discharged alive after a first-time IE hospitalization in the period 1996 to 2014. These were matched by age, sex, calendar year, and relevant comorbidities with the background population in a 1:1 ratio. The 1-year rate of nursing home admission and initiation of domiciliary care, respectively, were assessed by multivariable Cox regression analyses.

Results: In total, 4,493 IE patients were matched with 4,493 control subjects from the background population (median age: 66.8 years; interquartile range: 54.1, 76.7; 67.8% men). The 1-year incidence of nursing home admission was significantly higher among IE patients compared with the matched population (3.4% vs. 1.0%; hazard ratio: 7.95; 95% confidence interval: 4.00–15.77). Furthermore, IE patients had an increased use of domiciliary care compared with the matched population (6.6% vs. 2.1%; hazard ratio: 4.39; 95% confidence interval: 2.74–7.05). Factors associated with an increased risk of nursing home admission and domiciliary care among IE patients included older age, living alone, longer length of hospital stay, cardiovascular comorbidities, and stroke during admission.

Conclusions: Patients who survived IE had an 8× higher incidence of nursing home admission and a 4× higher incidence of initiation of domiciliary care than their counterparts from the matched population.

Highlights

  • We found that patients who survive IE have an 8× higher incidence of nursing home admission and a 4× higher incidence of initiation of domiciliary care than their counterparts from the matched population.
  • We show that IE is associated with debilitating physical and mental changes that are necessary to consider assessing the severity of IE and the follow-up on patients surviving IE.
  • We believe that this paper contributes important research findings emphasizing the importance of the follow-up on patients surviving IE.
How to Cite: Havers-Borgersen E, Fosbøl EL, Rørth R, Kragholm K, Kristensen SL, Bundgaard H, et al.. Nursing Home Admission and Initiation of Domiciliary Care Following Infective Endocarditis. Global Heart. 2019;14(1):41–6. DOI: http://doi.org/10.1016/j.gheart.2019.01.002
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Published on 01 Mar 2019.
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