Electronic Thesis and Dissertation Repository


Master of Science


Epidemiology and Biostatistics


Stranges, Saverio

2nd Supervisor

Silverman, Michael



Infective endocarditis is an infectious disease that affects the valves of the heart. Injection drug use is currently a leading risk factor among patients with endocarditis. We conducted a prospective study using data from hospital chart records among patients with endocarditis in London, Ontario, which has a relatively high prevalence of people who inject drugs to assess the severity of the issue and the major risk factors of mortality pertaining to this population. This study had a sample size of 353 and included a review of the incidence of admissions of endocarditis, as well as a survival analysis, using both univariate and multivariate methods. We found the incidence to be rising among both people who inject drugs and those who do not. In the total group, the use of injection drugs (HR: 2.50, 95% C.I. 1.41 to 4.34), age (HR: 1.03 per year, 95% C.I. 1.01 to 1.05), methicillin resistant staphylococcus aureus infection (HR: 3.23, 95% C.I. 1.79 to 5.84) and methicillin sensitive staphylococcus aureus (HR:1.74, 95% C.I. 1.05 to 2.87) infection were shown to be significantly associated with all-cause mortality. With the ongoing proliferation of injection drug use, additional harm reduction strategies to further reduce the incidence and impact of endocarditis among people who inject drugs is important.