Pattern and predictors of outcomes for infective endocarditis in North Kuala Lumpur

Abstract

Context: Infective endocarditis (IE) still carries significant mortality and morbidity ever since 1835. Despite improvement in medical technologies, mortality outcome remains unchanged. We sought to analyze the pattern of presentation, treatment, and outcomes predictors for patient presenting to our hospital. This study will explore some of the factors that could be associated with the outcome of a patient diagnosed with IE for a better guidance in management. Subjects and Methods: This is a retrospective dual center cohort study from North Kuala Lumpur from January 2012 to December 2013. Fifty patients with definite IE based on modified Duke's criteria were recruited into the study. Clinical presentation, risk factors, biochemical markers, echocardiography, and outcome were obtained through chart review, clinic data, and telephone call. Simple logistic regression was utilized for inferential statistic. Results: A total of 50 patients, 37 (74%) males and 13 (26%) females were included in the study. The mean age was 42 ± 16.4. Most patients (80.39%) were diagnosed within the 1st week of admission. Staphylococcus aureus was the most common pathogen (38%) and the mitral valve was predominantly affected (68%). Complication was common and in-hospital mortality remains high (28%). Nearly 20% of the patients who had surgical intervention survived and discharged alive. Presence of complications predicts poor outcome (odds ratio [OR]: 5.5 P = 0.02), whereas surgical intervention predicts good outcome (OR: 1.56 P = 0.027). Conclusions: Mortality remains relatively high in patient with IE. Those who presented with complications are at 5.5-fold risk of mortality. Surgical intervention showed an association with good outcome within this cohort.