Infectious Disease · Public Health · 2 h ago
US Drug-Associated Endocarditis Hospitalizations Declined After 2020 as Stimulant Involvement Rose
A nationally representative analysis estimated 118,190 adult hospitalizations for drug use-associated infective endocarditis (DUA-IE) in the United States from 2016 to 2022. Overall hospitalizations fell after peaking in 2020, while stimulant-only and combined opioid-stimulant cases made up a growing share, with regional differences.
- DUA-IE hospitalizations peaked in 2020, then declined.
- Opioid-only cases decreased as stimulant involvement increased.
- Stimulant involvement was most likely in the Pacific division.
Researchers analyzed a representative sample of US adult hospitalizations from 2016 through 2022 to estimate national and regional trends in drug use-associated infective endocarditis (DUA-IE). They examined cases by drug category and census division and used weighted logistic regression to assess the probability of stimulant involvement across patient and hospital characteristics.
An estimated 118,190 DUA-IE hospitalizations occurred during the study period. Annual hospitalizations peaked at 18,735 in 2020, then declined to 15,345 in 2022. The proportion involving opioids alone fell from 49.4% in 2016 to 39.9% in 2022. Over the same period, opioid-stimulant co-use rose from 22.6% to 28.6%, and stimulant-only cases rose from 14.7% to 18.3%. Stimulants surpassed opioids in several Western census divisions. The estimated probability of stimulant involvement was highest in the Pacific division (0.59; 95% CI, 0.56–0.62) and lowest in New England (0.34; 95% CI, 0.31–0.38).
The findings indicate a changing hospitalized DUA-IE burden, not evidence that particular harm-reduction or treatment efforts caused the decline. The analysis relies on hospitalization data and does not establish why trends changed; its estimates describe US adults and should not be interpreted as direct measures of incidence in the wider population.
In practice
The findings may help clinicians and public health teams recognize that stimulant involvement is an increasingly prominent feature of hospitalized drug use-associated infective endocarditis, especially in Western US divisions. They support attention to changing local drug-use patterns when planning prevention and care services, but do not show which interventions reduce hospitalizations or establish a treatment change. The analysis covers hospitalizations rather than all disease in the population, and its estimates are specific to the United States from 2016 to 2022.
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Clinical Infectious Diseases: Changing National and Regional Trends in Drug Use-Associated Infective Endocarditis From 2016 to 2022 ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.