Abstract
BackgroundTo explore the trends in epidemiology and the risk factors related to the prognosis of infective endocarditis in a tertiary hospital over the past ten years.MethodsA retrospective cohort study was performed. A total of 407 consecutive patients who were admitted with infective endocarditis were included. The clinical characteristics and the risk factors related to the prognosis of infective endocarditis during this period were analyzed.ResultsA total of 407 patients with infective endocarditis were included, the average age was 48 ± 16 years old with an increasing trend and in-hospital mortality rate was 10.6% and one-year mortality rate was 11.3%. Among patients with underlying heart disease, congenital heart disease was the most common (25.8%), followed by rheumatic heart disease (17.0%) which showed a decreased trend during this period (P < 0.001). There were 222(54.5%) patients with positive blood cultures results and Streptococci (24.6%) was the main pathogens with an increasing trend. There were 403 patients (99%) with surgical indications, but only 235 patients (57.7%) received surgical treatment. Hemodialysis (P = 0.041, OR = 4.697, 95% CI 1.068–20.665), pulmonary hypertension (P = 0.001, OR = 5.308, 95% CI 2.034–13.852), Pitt score ≥ 4 (P < 0.001, OR = 28.594, 95% CI 5.561–148.173) and vegetation length>30 mm (P = 0.011, OR = 13.754, 95% CI 1.832–103.250) were independent risk factors for in-hospital mortality.ConclusionsThere were no significant changes in the overall incidence of infective endocarditis, but the clinical features of infective endocarditis had slightly changed during the past ten years. Streptococci infective endocarditis was still the predominant. Patients with hemodialysis, pulmonary hypertension, Pitt score ≥ 4 and vegetation length>30 mm had an worse in-hospital outcome.
Highlights
To explore the trends in epidemiology and the risk factors related to the prognosis of infective endocarditis in a tertiary hospital over the past ten years
We found that the mean age at the time of Infective endocarditis (IE) episodes were younger than those reported from developed countries, the mean age increased during this period
We found that hemodialysis, pulmonary hypertension, Pitt score ≥ 4 and vegetation length>30 mm were independent risk factors for in-hospital mortality
Summary
To explore the trends in epidemiology and the risk factors related to the prognosis of infective endocarditis in a tertiary hospital over the past ten years. Infective endocarditis (IE) is an infectious disease involving the heart valve or endocardium caused by causative microorganisms. It is a severe disease with high morbidity and mortality [1]. Serious complications such as heart failure and cerebral embolism are common. Over the past two decades, with the increase in life expectancy, the increased use of cardiac implant devices, and the frequency in invasive procedures, the epidemiology of IE in developed countries such as the Europe and the United States has changed significantly: older patients with IE gradually increased, prosthetic valve endocarditis (PVE) and cardiac device–related endocarditis increased, and Staphylococci has become the most predominated pathogen [4]
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