504 Infective Endocarditis at a Tertiary Hospital in Adelaide, Australia

Abstract

Infective endocarditis (IE) is a deadly disease associated with significant morbidity and mortality. The most commonly used diagnostic criteria is the modified Duke criteria which classifies patients into definite, possible, and rejected IE. A retrospective single centre cohort study of 265 patients with possible IE and definite IE as per the modified Duke criteria, that were managed at Flinders Medical Centre from 2007 to 2018. We sought to compare the morbidity and mortality from 30 days up to 12 months, among patients with possible IE and those with definite IE managed at a tertiary hospital in Adelaide, Australia. 178 had definite IE and 87 had possible IE. There were no significant differences between definite IE vs possible IE for the following: median intensive care length of stay (132hrs vs 125.5hrs, p=0.52); 30 day readmission (5.6% vs 5.8%, p=0.966); 6 month readmission (34.3% vs 35.6%, p=0.827); 12 month readmission (43.3% vs 51.7%, p=0.194); 30 day mortality (9% vs 8.1%, p=0.798); 6 month mortality (15.2% vs 17.2%, p=0.664) and 12 mortality (17.4% vs 19.5%, p=0.673). There was a significant difference in length of initial hospital stay between definite IE vs possible IE (40.3 days vs 30.1 days, p=0.0002). In our cohort, there were no significant differences in morbidity and mortality for patients with possible IE at 30 days up to 12 months, compared to those with definite IE. We suggest for more aggressive diagnostic, surveillance and therapeutic considerations for patients with possible IE.