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Abstract
Objectives: To investigate the changes in characteristics of patients with infective endocarditis in Iran and comparing the results with the changing profiles of Infection Endocarditis (IE) in other countries. Methodology: We studied all patients with definite or possible IE seen at four referral teaching hospitals in Iran from Jan. 1995 to Dec. 2010. The data was analyzed both collectively and separately in two consecutive eight-year periods, i.e. 1995-2003 and 2004-2010. Results: A total of 286 episodes of IE, 172 males and 114 females, were reviewed from which 162 ones were in the first eight-year time period and 124 episodes in the second one. Mean age of the patients was significantly increased in the second eight-year period (24.2±11 vs 39.4±15 years old, p value = 0.01). Increase in the episodes caused by Staphylococcus aureus was significant (40.7% vs 22.8%, p value = 0.01). The mean size of the vegetation was noticeably higher among IDUs than non-IDUs (1.53±0.1cm vs 0.76±0.2cm, p value < 0.001). As well as extra cardiac complications, mortality rate was noticeably higher among the patients with vegetation size ≥ 1cm (34.4% vs 16.3%, p value = 0.003). There was not a significant difference regarding the mortality rate between the conservatively and surgically treated patients (20.7% vs 22.9%, p value = 0.07). Conclusion: The most important changing characteristic of IE which influences the outcome of the disease seems to be vegetation size which can account for as the outcome predictor.
Highlights
Known as a serious infection of heart valves, Infective Endocarditis (IE) is still associated with high mortality and morbidity despite advances in medical and surgical interventions.[1,2,3] Historically, infective endocarditis was a disease which occurred predominantly in patients with an underlying heart problem, congenital heart disease (CHD) and Rheumatic heart disease (RHD)
We investigated the situation of all patients with definite or possible IE seen at four referral teaching Medical Centers affiliated by Shahid Beheshti University of Medical Sciences (Loghman Hakim, Shahid Modarres, Labbafinejad and Bu-Ali Hospitals) in Tehran, Iran, from Jan. 1995 to Dec. 2010 in an effort to identify the changes in the characteristics of patients with infective endocarditis in Iran and to compare the results with the changing profile of IE in other countries
There was a significant increase in the mean age of the patients in the second eightyear period of time compared to the first interval (24.2±11 vs 39.4±15 years old, p value = 0.01)
Summary
Known as a serious infection of heart valves, Infective Endocarditis (IE) is still associated with high mortality and morbidity despite advances in medical and surgical interventions.[1,2,3] Historically, infective endocarditis was a disease which occurred predominantly in patients with an underlying heart problem, congenital heart disease (CHD) and Rheumatic heart disease (RHD). About one-half of all IE cases occurs in patients over the age of 60 and the median age of patients has increased steadily during the past decades.[3,12]
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