The New Zealand medical journal · 2009
Outcome and prognostic factors on 57 cases of infective endocarditis in a single centre.
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Wong Chi Wing, Porter Graeme, Tisch Jonathan, Young Calum
Аннотация
AIM: We aim to evaluate the clinical characteristics and outcome of infective endocarditis in our hospital, and the prognostic significance of recurrent endocarditis.
METHODS: A single centre retrospective review of all cases of infective endocarditis (IE) was undertaken for a 5-year period from June 2002.
RESULTS: There were 57 episodes of IE in 47 patients. Seventy percent were definite IE using the modified Duke Criteria (2000). The most commonly isolated organisms were Streptococci (37%) and Staphylococcus aureus (35%). Forty-nine percent of patients remained event-free from death, recurrence, or operation at the end of follow-up period. Five cases (8.5%) had early recurrence of endocarditis within 60 days. Eleven patients (23%) died during follow-up (mean 14 months). There was no significant increase in mortality of patients with history of recurrent endocarditis (38% vs 28%; p=0.39). Staphylococcus aureus was associated with increased mortality or need for valve surgery (OR 4.5; 95%CI 1.38-14.8), risk of neurological events (OR 8.9; 1.5-52), renal failure (OR 7.2; 1.7-30) and thrombocytopenia (OR 5.6; 1.4-22).
CONCLUSIONS: The mortality of IE remains high. Less than half of this cohort remained event-free. The micro-organism involved is more predictive of mortality or need for surgery than recurrent endocarditis.
METHODS: A single centre retrospective review of all cases of infective endocarditis (IE) was undertaken for a 5-year period from June 2002.
RESULTS: There were 57 episodes of IE in 47 patients. Seventy percent were definite IE using the modified Duke Criteria (2000). The most commonly isolated organisms were Streptococci (37%) and Staphylococcus aureus (35%). Forty-nine percent of patients remained event-free from death, recurrence, or operation at the end of follow-up period. Five cases (8.5%) had early recurrence of endocarditis within 60 days. Eleven patients (23%) died during follow-up (mean 14 months). There was no significant increase in mortality of patients with history of recurrent endocarditis (38% vs 28%; p=0.39). Staphylococcus aureus was associated with increased mortality or need for valve surgery (OR 4.5; 95%CI 1.38-14.8), risk of neurological events (OR 8.9; 1.5-52), renal failure (OR 7.2; 1.7-30) and thrombocytopenia (OR 5.6; 1.4-22).
CONCLUSIONS: The mortality of IE remains high. Less than half of this cohort remained event-free. The micro-organism involved is more predictive of mortality or need for surgery than recurrent endocarditis.
Предметные рубрики MeSH
AdolescentAdultAgedAged, 80 and overAnti-Bacterial AgentsAortic ValveBioprosthesisCohort StudiesCombined Modality TherapyDisease-Free SurvivalEchocardiographyEndocarditis, BacterialFemaleFollow-Up StudiesHeart Valve ProsthesisHumansMaleMethicillin-Resistant Staphylococcus aureusMiddle AgedMitral ValveNew ZealandPacemaker, ArtificialRecurrenceRetrospective StudiesRisk FactorsStaphylococcal InfectionsStreptococcal InfectionsYoung Adult