1989. Prognostic Factors Associated With In-hospital Mortality In Patients With Infective Endocarditis In 4 Colombian Hospitals From 2007 To 2017

Abstract

Abstract Background In Colombia there are few studies on the behavior of this disease, with incidence reports of 8.3 patients per 100,000 inhabitants per year. This study is the first to be carried out in several centers in the country with the aim of reaching a representative number of patients with endocarditis, and thus reflect the behavior of this pathology in Colombia, determining possible associations with prognostic factors for mortality. Methods Observational, multicenter, analytical, historical cohort study, which was carried out in 4 high-complexity hospitals in Colombia from 2007 to 2017. The target population was adult patients hospitalized between 2007 and 2017 in the hospitals of: Fundación cardioinfantil (Bogotá), Hospital Mayor de Méderi (Bogotá), Shaio Clinical Foundation (Bogotá), and the Cardiovascular Foundation of Colombia (Bucaramanga) with a diagnosis of definitive infective endocarditis. As inclusion criteria, patients over 18 years of age hospitalized in these institutions and who met the definitive infective endocarditis criteria according to the modified Duke criteria were taken into account. Those patients without complete information in the clinical history for the collection of variables were excluded. Results 308 patients were included In hospital mortality was 32.7%. The main prognostic variables were: Complication with renal replacement therapy OR 6,669 CI 3.77 - 12.17, p< 0.001, moderate mitral compromise OR 3.9 CI 1.02-17.5, p=0.057, renal replacement therapy (RRT) prior to hospitalization OR 3.72 CI 1.89 - 7.51, p < 0.001 and central nervous system embolism OR 2.6 CI 1.53 - 4.44, p< 0.001. As protective factors: surgery during hospitalization OR 0.39 CI 0.24 - 0.64, p< 0.001 and tricuspid involvement OR 0.39 IC 0.15 - 0.87, p=0.032. Multivariate analysis of mortality with prehospital variables in patients with infective endocarditis. Abbreviations: GFR, Glomerular Filtration Rate. CKD-EPI, Chronic kidney disease epidemiology collaboration. LVEF, Left Ventricular Ejection Fraction Multivariate analysis of mortality with hospital variables in patients with infective endocarditis Abbreviations: RRT, renal replacement therapy. CNS, Central nervous system, mm: millimeters. ROC curve of the mortality prediction model with pre-hospital variables Conclusion Both the epidemiological characteristics and in-hospital mortality are similar to those reported in international studies. The main prognostic factor associated with in-hospital mortality was the development of acute kidney injury with indication for RRT. Disclosures All Authors: No reported disclosures.