Significant Increase in Mortality and Risk of Acute Ischemic Stroke in Infective Endocarditis Patients With Subarachnoid Hemorrhage Secondary to Mycotic Aneurysms
Student, Resident/Fellow, Faculty
Infective Endocarditis (IE) patients are known to have a variety of complications with one of the rarest, but serious being cerebral mycotic aneurysm, which can result in subarachnoid hemorrhage (SAH). Using the National In-Patient Sample database, we sought to determine the rate of acute ischemic stroke (AIS) and outcomes in IE- patients with and without SAH. In total, we identified 82,844 IE-patients from 2010 to 2016, of which 641 had a concurrent diagnosis of SAH. IE patients with SAH had a more complicated course, higher mortality rate (OR 4.65 CI 95% 3.9-5.5, P < 0.001), and worse outcomes. This patient population also had a significantly higher rate of AIS (OR 6.3 CI 95% 5.4-7.4, P < 0.001). Overall, 41.5% of IE-patients with SAH had AIS during their hospitalization as compared to 10.1% of IE only patients. IE-patients with SAH were more likely to undergo endovascular treatment (3.6%) with 0.8% of the IE patients with AIS undergoing mechanical thrombectomy. While IE-patients are at risk for various complications, our study suggests a significant increase in the mortality and risk of AIS in those with SAH.
Sursal, T., Clare, K., Feldstein, E., Ogulnick, J., Nolan, B., Karimov, Z., Nazarenko, A., Ye, L., Bornovski, Y., Wong, S., Goldberg, J., Mayer, S. A., Bauerschmidt, A., El Khoury, M. Y., Al-Jehani, H., Gandhi, C. D., & Al-Mufti, F. (2023). Significant Increase in Mortality and Risk of Acute Ischemic Stroke in Infective Endocarditis Patients With Subarachnoid Hemorrhage Secondary to Mycotic Aneurysms. https://doi.org/10.1016/j.jns.2023.120670