Abstract
Infective endocarditis (IE) is a severe disease with a hospital mortality rate of 17–25%. Early identification of IE patients with high risk of mortality may improve their clinical outcomes. Patients with diabetes mellitus (DM) who develop infective diseases are associated with worse outcomes. This study aimed to define the impact of DM on long-term mortality in IE patients. A total of 412 patients with definite IE from February 1999 to June 2012 were enrolled in this observational study and divided into 2 groups: group 1, patients with DM (n = 72) and group 2, patients without DM (n = 340). The overall in-hospital mortality rate for both groups combined was 20.2% and was higher in group 1 than in group 2 (41.7% vs. 16.5%, p < 0.01). Compared to patients without DM, patients with DM were older and associated with higher incidence of chronic diseases, less drug abuse, higher creatinine levels, and increased risk of Staphylococcus aureus infection (all p < 0.05). Moreover, they were more likely to have atypical clinical presentation and were associated with longer IE diagnosis time (all p < 0.05). In multivariable analysis, DM is an independent and significant predictor of mortality. The prognosis of IE patients with DM is still poor. Early identification and more aggressive treatment may be considered in IE patients with DM.
Highlights
Infective endocarditis (IE) is a relatively rare cardiovascular disease, it remains a severe disease with a hospital mortality rate of 17% to 25% [1,2,3].Despite the availability of advanced diagnostic tools and new medications, the mortality rate of infective endocarditis (IE) remains unchanged [1,2,3,4,5]
The in-hospital mortality rate of this study was 21.4%, which is consistent with the range reported in the previous studies [36,37,38], and it did not decrease despite the availability of advanced diagnostic tools and treatment in the twenty-first century
Our present study and the other studies [22] found that diabetes mellitus (DM) is an independent predictor of in-hospital mortality after adjusting the other confounding factors
Summary
Infective endocarditis (IE) is a relatively rare cardiovascular disease, it remains a severe disease with a hospital mortality rate of 17% to 25% [1,2,3].Despite the availability of advanced diagnostic tools and new medications, the mortality rate of IE remains unchanged [1,2,3,4,5]. Infective endocarditis (IE) is a relatively rare cardiovascular disease, it remains a severe disease with a hospital mortality rate of 17% to 25% [1,2,3]. Early identification of IE patients with high risk of in-hospital mortality and management of their individual characteristics may improve their clinical outcomes. Patients with diabetes mellitus (DM) have a higher incidence and increased severity and risk of complications of bacterial infections [6,7,8]. DM has been identified as a significant predictor of poor prognosis in different bacterial infections and cardiovascular diseases [6,7,8,9,10,11]. Decreased activation, chemotaxis, and phagocytosis of polymorphonuclear neutrophils and monocytes are found in patients with
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