IMPACT OF FINANCIAL CONSTRAINTS ON SURVIVAL OUTCOMES IN PATIENTS WITH INFECTIVE ENDOCARDITIS
Main Article Content
Keywords
Infective endocarditis, financial constraints, survival outcomes, healthcare access, Pakistan.
Abstract
Objectives: To find out how resource constraint cost influences the survival of patients diagnosed with IE in a hospital setting in Pakistan.
Materials and Methods: The target population of this retrospective cohort study was 120 patients who had received an IE diagnosis at Peshawar Institute of Cardiology, Pakistan from January 2022 to December 2023. Making of some data includes demographic characteristics, concurrent diseases, microbiological results, delays in treating period due to financial problems, and survival status. For identification of the relationship between restrictions by financial resources and survival, the multivariate regression test models were used.
Results: Overall, 120 parties admitted to facing financial difficulties in availing diagnostic and treatment services with 42 percent of them being patients. Patients with impaired financial status had more in-hospital (25% vs 10%, p < 0.05) and overall (35% vs 15%, p < 0.05) mortality rates. Multivariate analysis revealed that financial constraints were independently associated with poorer survival outcomes (HR: 1.9, p < 0.05).
Conclusion: Limited financial resources remain an essential determinant of the outcome of infective endocarditis inflammatory processes, demonstrating the necessity of increasing access to medical care in low-income countries.
References
2- Shah, A.S., McAllister, D.A., Gallacher, P., Astengo, F., Rodríguez Pérez, J.A., Hall, J., Ken Lee, K., Bing, R., Anand, A., Nathwani, D. and Mills, N.L., 2020. Incidence, microbiology, and outcomes in patients hospitalized with infective endocarditis. Circulation, 141(25), pp.2067-2077.
3- Cosyns, B., Roosens, B., Lancellotti, P., Laroche, C., Dulgheru, R., Scheggi, V., Vilacosta, I., Pasquet, A., Piper, C., Reyes, G. and Mahfouz, E., 2021. Cancer and infective endocarditis: characteristics and prognostic impact. Frontiers in Cardiovascular Medicine, 8, p.766996.
4- Cuervo, G., Escrihuela-Vidal, F., Gudiol, C. and Carratalà, J., 2021. Current challenges in the management of infective endocarditis. Frontiers in medicine, 8, p.641243.
5- Straw, S., Baig, M.W., Gillott, R., Wu, J., Witte, K.K., O’regan, D.J. and Sandoe, J.A., 2020. Long-term outcomes are poor in intravenous drug users following infective endocarditis, even after surgery. Clinical Infectious Diseases, 71(3), pp.564-571.
6- Bohbot, Y., Habib, G., Laroche, C., Stöhr, E., Chirouze, C., Hernandez‐Meneses, M., Melissopoulou, M., Mutlu, B., Scheggi, V., Branco, L. and Olmos, C., 2022. Characteristics, management, and outcomes of patients with left‐sided infective endocarditis complicated by heart failure: a substudy of the ESC‐EORP EURO‐ENDO (European infective endocarditis) registry. European journal of heart failure, 24(7), pp.1253-1265.
7- Gros, A., Seguy, B., Bonnet, G., Guettard, Y.O., Pillois, X., Prevel, R., Orieux, A., Ternacle, J., Préau, S., Lavie-Badie, Y. and Coupez, E., 2024. Critically ill patients with infective endocarditis, neurological complications and indication for cardiac surgery: a multicenter propensity-adjusted study. Annals of Intensive Care, 14(1), p.21.
8- Scheggi, V., Merilli, I., Marcucci, R., Del Pace, S., Olivotto, I., Zoppetti, N., Ceschia, N., Andrei, V., Alterini, B., Stefàno, P.L. and Marchionni, N., 2021. Predictors of mortality and adverse events in patients with infective endocarditis: a retrospective real world study in a surgical centre. BMC cardiovascular disorders, 21, pp.1-9.
9- Mir, T., Uddin, M., Qureshi, W.T., Regmi, N., Tleyjeh, I.M. and Saydain, G., 2022. Predictors of complications secondary to infective endocarditis and their associated outcomes: a large cohort study from the national emergency database (2016–2018). Infectious Diseases and Therapy, 11(1), pp.305-321.
10- Iaccarino, A., Barbone, A., Basciu, A., Cuko, E., Droandi, G., Galbiati, D., Romano, G., Citterio, E., Fumero, A., Scarfò, I. and Manzo, R., 2023. Surgical Challenges in Infective Endocarditis: State of the Art. Journal of Clinical Medicine, 12(18), p.5891.
11- Arregle, F., Martel, H., Philip, M., Gouriet, F., Casalta, J.P., Riberi, A., Torras, O., Casalta, A.C., Camoin-Jau, L., Lavagna, F. and Renard, S., 2021. Infective endocarditis with neurological complications: delaying cardiac surgery is associated with worse outcome. Archives of cardiovascular diseases, 114(8-9), pp.527-536.
12- Khaloo, P., Uzomah, U.A., Shaqdan, A., Ledesma, P.A., Galvin, J., Ptaszek, L.M. and Ruskin, J.N., 2022. Outcomes of patients hospitalized with cardiovascular implantable electronic device–related infective endocarditis, prosthetic valve endocarditis, and native valve endocarditis: a nationwide study, 2003 to 2017. Journal of the American Heart Association, 11(17), p.e025600.
13- Bea, C., Vela, S., Garcia-Blas, S., Perez-Rivera, J.A., Diez-Villanueva, P., de Gracia, A.I., Fuertes, E., Oltra, M.R., Ferrer, A., Belmonte, A. and Santas, E., 2022. Infective endocarditis in the elderly: challenges and strategies. Journal of Cardiovascular Development and Disease, 9(6), p.192.
14- Becher, P.M., Gossling, A., Fluschnik, N., Schrage, B., Seiffert, M., Schofer, N., Blankenberg, S., Kirchhof, P., Westermann, D. and Kalbacher, D., 2024. Temporal trends in incidence, patient characteristics, microbiology and in-hospital mortality in patients with infective endocarditis: a contemporary analysis of 86,469 cases between 2007 and 2019. Clinical Research in Cardiology, 113(2), pp.205-215.
15- Arregle, F., Iline, N., Giorgi, R., Philip, M., Hubert, S., Gouriet, F., Casalta, J.P., Collart, F., Riberi, A., Martel, H. and Renard, S., 2022. Influence of the healthcare pathway on the outcome of patients with infective endocarditis. European Heart Journal: Acute Cardiovascular Care, 11(9), pp.672-681.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Hidayatullah
Senior Register, Peshawar Institute of Cardiology, Pakistan
Ali Raza
Assistant professor, Peshawar Institute of Cardiology, Pakistan
Shama Ayaz
Register, Peshawar Institute of Cardiology, Pakistan
Fazli Akbar
Assistant professor, Peshawar Institute of Cardiology, Pakistan
Syed Alishan
Assistant professor, Peshawar Institute of Cardiology, Pakistan
Marjeena
Medical Officer, Peshawar Institute of Cardiology, Pakistan