A new study has found that both cardiac surgery and in-hospital addiction counselling are linked to significantly reduced death rates in injection drug users with first-episode endocarditis, an infection of the heart valves.
Surgery was associated with a 56 per cent reduction in mortality, while in-hospital addictions counselling was associated with a 72 per cent reduction.
Cases of endocarditis have risen dramatically in London over the last few years.
Fifty-five per cent of people who experience heart valve infections are injection drug users and a third of them die as a result of the disease.
In an effort to improve outcomes, researchers at Lawson Health Research Institute and Western University studied which clinical factors are associated with improved survival in this patient population.
The project was a retrospect cohort study that examined anonymous patient data from 2007 to 2016 at London Health Sciences Centre and St. Joseph’s Health Care of London.
“In the past, many centres have not performed cardiac surgery in patients who inject drugs due to concerns about poor outcomes. Continued drug use was viewed as a risk for reinfection,” says Dr. Michael Silverman, author of the study, Lawson Scientist and Chair/Chief of Infectious Diseases for Western’s Schulich School of Medicine & Dentistry, LHSC and St.Joseph’s.
“Our study challenges those beliefs. It shows that when we account for the severity of a patient’s illness, they’re more likely to survive with surgery."
Dr. Sharon Koivu, author of the study, Lawson scientist, associate professor at Schulich and palliative-care physician at LHSC says, “Education and support for these patients is critical. The majority of the patients I see don’t understand what they’re doing to cause an infection and may be highly motivated to undertake a lifestyle change."
She adds, “This study shows the importance of working with patients towards harm reduction and addiction recovery while they’re still being treated in-hospital.”
