OUTCOME AND PROGNOSTIC FACTORS ON 57 CASES OF INFECTIVE ENDOCARDITIS IN A SINGLE CENTRE

Abstract

A single centre retrospective review of all cases of IE for a 5-year period from June 2002. There were 57 episodes of IE in 47 patients. Seventy percent were definite IE using modified Duke Criteria (2000). Forty-five episodes were native valve endocarditis, the remaining were prosthetic valve endocarditis and one case of pacemaker lead endocarditis. The mitral valve was most commonly involved. Mean age was 66 with bimodal peak at age group 21–30 and 81–90. The most commonly isolated organisms were Streptococci (37%) and Staphylococcus aureus (35%). Forty-nine percent of patients remained event-free (survive without recurrence or operation) at the end of follow-up period. Eight patients had recurrent endocarditis within the study period. Five cases (8.5%) had early recurrence of endocarditis within 60 days. Twelve patients (26%) died during follow-up (mean 14 months). There was no significant increase in mortality of patients with history of recurrent endocarditis (38% vs. 28%; p = 0.39). Staphylococcus aureus was associated with increased mortality or need for valve surgery (OR 4.5; 95% CI: 1.38–14.8), risk of neurological events (OR 8.9; 1.5–52), renal failure (OR 7.2; 1.7–30) and thrombocytopenia (OR 5.6; 1.4–22). Haematological parameters, renal function or inflammatory markers were not shown to be predictive of increased mortality or need for valve surgery.