Infective Endocarditis Hospitalizations in Kentucky, 2008-2018: Spatial and Temporal Trends

Authors

• Meera Marji, University of KentuckyFollow
• Steve Browning, University of KentuckyFollow
• W. Jay Christian, University of KentuckyFollow
• Richard Charnigo, University of KentuckyFollow
• Steve W. Leung, University of KentuckyFollow
• Anna Kucharska-Newton, University of North Carolina at Chapel HillFollow

Corresponding Author

Meera Marji;  Meera.Marji@uky.edu

Author Affiliations

1. Meera Marji, PhD, MBBS, MPH: Postdoctoral fellow, College of Medicine, University of Kentucky (Lexington, KY); E-mail: Meera.Marji@uky.edu; ORCiD: https://orcid.org/0009-0003-2057-7747
2. Steve Browning, PhD, MSPH: Associate professor, College of Public Health, University of Kentucky; ORCiD: https://orcid.org/0000-0001-7922-7459
3. W. Jay Christian, PhD, MPH: Associate professor, College of Public Health, University of Kentucky; ORCiD: https://orcid.org/0000-0001-6904-3971
4. Richard Charnigo, PhD, MS: Professor, College of Public Health, University of Kentucky; ORCiD: https://orcid.org/ 0000-0002-5259-8038
5. Steve Leung, MD: Professor, College of Medicine, University of Kentucky Medical Center (Lexington, KY); ORCiD: https://orcid.org/ 0000-0003-2832-2258
6. Anna Kucharska-Newton, PhD, MPH: Associate professor, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (Chapel Hill, NC); ORCiD: https://orcid.org/0000-0001-9864-467X

Author Area of Expertise

Meera Marji: Epidemiology and Public Health

Steve Browning: Epidemiology and Public Health

Jay Christine: Epidemiology and Public Health

Richard Charring: Biostatistics

Steve Leung: Clinical cardiology

Anna Kucharska-Newton: Epidemiology and Public Health

Abstract

Introduction: Infective endocarditis (IE) hospitalization rates have increased significantly in the last decade, primarily due to the opioid epidemic. In 2016, Kentucky (KY) ranked among the top ten states for opioid-related overdose deaths, but limited data exist on IE trends in KY.

Purpose: This study seeks to examine county-level spatial and temporal trends in IE hospitalization rates in KY.

Methods: Hospital inpatient discharge data from 2008–2018 for KY residents aged 18 and older were analyzed. IE admissions and drug use status were identified using ICD-9 & 10 diagnosis codes. U.S. Census data calculated yearly IE hospitalization rates per 100,000 residents. Joinpoint regression identified periods with significant rate changes and calculated annual percent change (APC). Poisson modeling in SaTScan conducted spatiotemporal cluster analysis at the county level and calculated the relative risk (RR) of IE hospitalizations within identified clusters.

Results: During 2008–2018, we observed 17,787 IE hospital admissions, including 3,577 associated with intravenous drug use (IDU-IE). Medicaid patients were more prevalent in the IDU-IE group compared to the non-IDU-IE group (75% vs. 15%). IDU-IE hospitalization rates increased from 1.2 to 27.3 per 100,000 residents between 2008 – 2018. Joinpoint regression for IDU-IE identified a significant upward trend from 2013–2018 with an APC of 71.3% (95% CI: 47.8, 98.5). The spatiotemporal analysis identified seven significant IE hospitalization clusters, with the largest (RR=2.06, p

Implications: IDU-IE hospitalization rates increased significantly from 2013–2018, while non-IDU-IE rates decreased over the study period.

DOI

https://doi.org/10.13023/jah.0801.03

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

Recommended Citation

Marji M, Browning S, Christian WJ, Charnigo R, Leung S, Kucharska-Newton A. Infective endocarditis hospitalizations in Kentucky, 2008-2018: spatial and temporal trends. J Appalach Health 2026; 8(1):22-41. DOI: https://doi.org/10.13023/jah.0801.03