US hospitalization rates for stroke associated with infective endocarditis (IE) and opioid use were stable for ≈2 decades but then sharply increased starting in 2008, coinciding with the emergence of the opioid epidemic, according to a recent study. Researchers used the 1993 to 2015 releases of the National Inpatient Sample and validated International Classification of Diseases, 9th Revision, Clinical Modification codes (ICD-9-CM) to identify hospitalizations with the combination of opioid abuse, IE, and stroke (defined as ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage). They found:

• From 1993 through 2015, there were 5,283 hospitalizations with stroke associated with IE and opioid use.
• Across this period, the rate of such hospitalizations increased from 2.4 to 18.8 per 10 million US residents.
• Joinpoint regression detected 2 segments: no significant change in the hospitalization rate was apparent from 1993 to 2008 (annual percentage change, 1.9%), and then rates significantly increased from 2008 to 2015 (annual percentage change, 20.3%), most dramatically in non-Hispanic white patients in the Northeastern and Southern US.