Clinical Characteristics and Outcomes of Patients with Cirrhosis Who Develop Infective Endocarditis

TL;DR

Patients with cirrhosis who develop infective endocarditis face a higher risk of decompensation and all-cause mortality compared to those without cirrhosis.

Contribution

This study is one of the first to analyze outcomes of infective endocarditis specifically in patients with cirrhosis.

Findings

27.3% of cirrhosis patients experienced decompensation within two years of IE admission.

Cirrhosis patients had a higher 2-year all-cause mortality risk (HR = 2.85) compared to non-cirrhosis patients.

Clinical features and IE-related mortality were similar between cirrhosis and non-cirrhosis groups.

Abstract

Background: Infective endocarditis (IE) is an increasingly common infection that results in significant morbidity and mortality. An important but under-analyzed subpopulation of patients with IE are those with concomitant cirrhosis. This study compared the characteristics and outcomes of patients with and without cirrhosis who were hospitalized with IE. Methods: The authors conducted a retrospective cohort study in adult patients with IE admitted at a single center from 2010 to 2020, comparing outcomes between those with and without cirrhosis at the time of admission. Results: A total of 22 patients with a history of cirrhosis and 356 patients without a history of cirrhosis were included. Over a quarter (27.3%) of those with cirrhosis experienced a decompensation event within two years of their admission for IE. Clinical features, microbiology, and direct complications from IE were largely similar between groups. There was no significant difference in IE-related mortality rates between groups, although, in an overall survival analysis, the group with cirrhosis did have a higher risk of all-cause mortality at 2 years (HR = 2.85; p = 0.012). Conclusions: This study highlights that IE in patients with cirrhosis may contribute to or trigger decompensation events. Further research is warranted to better understand morbidity outcomes in patients with cirrhosis who develop IE.

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