TY - JOUR
T1 - Active infective endocarditis
T2 - Clinical characteristics and factors related to hospital mortality
AU - Rostagno, Carlo
AU - Rosso, Gabriele
AU - Puggelli, Francesco
AU - Gelsomino, Sandro
AU - Braconi, Lucio
AU - Montesi, Gian Franco
AU - Romagnoli, Stefano
AU - Stefano, Pier Luigi
AU - Gensini, Gian Franco
PY - 2010
Y1 - 2010
N2 - 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.
AB - 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.
KW - Echocardiography
KW - Endocarditis
KW - Prognosis
KW - Surgery
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M3 - Article
C2 - 21154258
AN - SCOPUS:79251485286
VL - 17
SP - 566
EP - 573
JO - Cardiology Journal
JF - Cardiology Journal
SN - 1897-5593
IS - 6
ER -