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Active infective endocarditis: Clinical characteristics and factors related to hospital mortality
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Abstract
Background: Little information exists on the clinical characteristics and factors related to hospital mortality in patients with active infective endocarditis referred for surgery.
Methods: Between January 1, 2003 and December 31, 2006, 86 patients (56 males, 30 females, mean age 59.2 years) with active infective endocarditis were referred to our Department (2.8% of overall hospitalizations). The relation of several clinical, laboratory and echocardiographic findings at admission with hospital mortality was evaluated.
Results: A native valve (NVE) was involved in 50/86; the other 30 had a prosthetic valve endocarditis (PVE). Six had pacemaker endocarditis. The aortic valve was involved more frequently than the mitral valve, both in NVE and PVE. The tricuspid valve was involved in four drug addicts; 51% of patients were in NYHA class III–IV. Staphylococci and streptococci were isolated in 69% of patients (39% vs 30%). Blood cultures were negative in 24%. Overall hospital mortality has been 11.6%. Two patients died before surgery, eight in the perioperative period. Hospital mortality was closely related to age, clinical and laboratory evidence of advanced septic condition (temperature > 38°C, leukocytosis and creatinine > 2.0 mg/dL) and hemodynamic impairment.
Conclusions: Active infective endocarditis is a significant cause of referral to heart surgery departments and hospital mortality is still > 10%. Clinical and laboratory parameters easily available at admission suggest that severe sepsis and/or hemodynamic impairment may be helpful in predicting the clinical outcome in this group of high risk patients. (Cardiol J 2010; 17, 6: 566-573)
Abstract
Background: Little information exists on the clinical characteristics and factors related to hospital mortality in patients with active infective endocarditis referred for surgery.
Methods: Between January 1, 2003 and December 31, 2006, 86 patients (56 males, 30 females, mean age 59.2 years) with active infective endocarditis were referred to our Department (2.8% of overall hospitalizations). The relation of several clinical, laboratory and echocardiographic findings at admission with hospital mortality was evaluated.
Results: A native valve (NVE) was involved in 50/86; the other 30 had a prosthetic valve endocarditis (PVE). Six had pacemaker endocarditis. The aortic valve was involved more frequently than the mitral valve, both in NVE and PVE. The tricuspid valve was involved in four drug addicts; 51% of patients were in NYHA class III–IV. Staphylococci and streptococci were isolated in 69% of patients (39% vs 30%). Blood cultures were negative in 24%. Overall hospital mortality has been 11.6%. Two patients died before surgery, eight in the perioperative period. Hospital mortality was closely related to age, clinical and laboratory evidence of advanced septic condition (temperature > 38°C, leukocytosis and creatinine > 2.0 mg/dL) and hemodynamic impairment.
Conclusions: Active infective endocarditis is a significant cause of referral to heart surgery departments and hospital mortality is still > 10%. Clinical and laboratory parameters easily available at admission suggest that severe sepsis and/or hemodynamic impairment may be helpful in predicting the clinical outcome in this group of high risk patients. (Cardiol J 2010; 17, 6: 566-573)
Keywords
endocarditis; surgery; prognosis; echocardiography
About this articleTitle
Active infective endocarditis: Clinical characteristics and factors related to hospital mortality
Journal
Issue
Pages
566-573
Published online
2010-12-08
Page views
720
Article views/downloads
1212
DOI
10.5603/cj.21304
Bibliographic record
Cardiol J 2010;17(6):566-573.
Keywords
endocarditis
surgery
prognosis
echocardiography
Authors
Carlo Rostagno
Gabriele Rosso
Francesco Puggelli
Sandro Gelsomino
Lucio Braconi
Gian Franco Montesi
Stefano Romagnoli
Pier Luigi Stefano
Gian Franco Gensini
