Introduction Infective endocarditis (IE) is associated with significant mortality. Studies have highlighted differences in the epidemiological profile of the IE population between countries of differing socioeconomic status and associated outcomes. Social deprivation has a measurable impact on cardiovascular health, but a paucity of evidence exists regarding the influence of social deprivation in IE.

Aim We assessed the impact of social deprivation on the demographics, admission characteristics and clinical outcomes of patient’s admitted with IE.

Methods 483 patient visits from December 2013 to February 2021 were included. Patient visits were allocated to either high, medium or low social deprivation tertile based on Index of Multiple Deprivation Decile (High n=163, Medium n= 154, Low n=166).

Results High social deprivation was associated with significantly higher early (30 day) all-cause mortality (P=0.044). Patients in the high social deprivation tertile were more like to be female (P=0.043), younger (P<0.001), intravenous drug users (P=0.011), dialysis-dependent (P=0.001), have a history of depression (P<0.001) and of Black ethnicity (P<0.001). There were no differences in inflammatory response or responsible organism. High social deprivation was associated with significantly less aortic (P=0.014) or prosthetic-valve (P=0.003) related infections but had higher cerebral microemboli (P=0.016), correlating with highest proportion of presentation with stroke (High 27.6%, Medium 20.8%, Low 23.5%). 38.9% of patients had a surgical indication and 75.0% of them went on to have inpatient surgery. High social deprivation had a significantly lower EuroSCORE II (P=0.022), but had the lowest rate of surgery when indicated (High 71.7%, Medium 76.9%, Low 76.3%). Multivariate analysis demonstrated white blood cell (WBC) count (P=0.039) and presentation with stroke (P=0.038) as predictors of mortality at 30 days, while WBC count (P=0.005), enterococcal infection (P<0.001) and EuroSCORE II (P<0.001) were predictors of mortality at 1 year. Inpatient surgery was a protective factor at both 30 days (P=0.038) and 1 year (P=0.013).

Conclusions High social deprivation was associated with significantly higher early all-cause mortality, likely associated with more frequent presentation with stroke and less frequent inpatient surgery when indicated.

Conflict of Interest None