Predictors of mortality in Vietnamese patients with infective endocartis

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Infective endocarditis (IE) has been associated with an elevated mortality rate despite major advances in diagnostic and therapeutic methods for the past decades. Purpose to evaluate predictors of in-hospital all-cause mortality in patients with IE. Methods This was a retrospective cross-sectional study among patients who were 15 years of age or older with the definite or probable diagnosis of IE according to the modified Duke criteria admitted to Cho Ray Hospital between January 1, 2015 and December 31, 2019. Patients whose medical records with insufficient data to collect were excluded from the study. The minimum sample size of the study was 99 patients. Results Of the 201 hospitalized patients with IE, 157 patients (78.1%) had definite diagnosis and 44 patients (21.9%) had probable diagnosis according to the modified Duke criteria. Men accounted for 65.2% and women accounted for 34.8%. The mean age of patients was 42.2±15.3. All-cause in-hospital mortality rate was 15.9%. Factors associated with in-hospital mortality in univariate analysis included sex, chronic kidney disease, prior heart failure, cough, Streptococci, Staphylococcus aureus, white blood cell count, estimated glomerular filtration rate, acute heart failure, septic shock, cerebral infarction, cerebral hemorrhage, and surgical treatment. Multivariate logistic regression analysis showed that five independent prognostic factors of in-hospital mortality were male gender (OR=0.33; 95% CI: 0.11–0.97; P=0.043); prior heart failure (OR=5.29; 95% CI: 1.42–19.65; P=0.013); estimated glomerular filtration rate (OR=0.98; 95% CI: 0.97–0.99; P=0.045); septic shock (OR=9.53; 95% CI: 1.76–51.76; P=0.009); and surgical treatment (OR=0.20; 95% CI: 0.05–0.75; P=0.017). Conclusions The rate of mortality in IE has remained high and its predictors should be taken into consideration to improve outcomes.