In:
BMC Cardiovascular Disorders, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
Abstract:
Mortality in infective endocarditis (IE) is still high, and the long term prognosis remains uncertain. This study aimed to identify predictors of long-term mortality for any cause, adverse event rate, relapse rate, valvular and ventricular dysfunction at follow-up, in a real-world surgical centre. Methods We retrospectively analyzed 363 consecutive episodes of IE (123 women, 34%) admitted to our department with a definite diagnosis of non-device-related IE. Median follow-up duration was 2.9 years. Primary endpoints were predictors of mortality, recurrent endocarditis, and major non-fatal adverse events (hospitalization for any cardiovascular cause, pace-maker implantation, new onset of atrial fibrillation, sternal dehiscence), and ventricular and valvular dysfunction at follow-up. Results Multivariate analysis independent predictors of mortality showed age (HR per unit 1.031, p 〈 0.003), drug abuse (HR 3.5, p 〈 0.002), EUROSCORE II (HR per unit 1.017, p 〈 0.0006) and double valve infection (HR 2.3, p 〈 0.001) to be independent predictors of mortality, while streptococcal infection remained associated with a better prognosis (HR 0.5, p 〈 0.04). Major non-fatal adverse events were associated with age (HR 1.4, p 〈 0.022). New episodes of infection were correlated with S aureus infection (HR 4.8, p 〈 0.001), right-sided endocarditis (HR 7.4, p 〈 0.001), spondylodiscitis (HR 6.8, p 〈 0.004) and intravenous drug abuse (HR 10.3, p 〈 0.001). After multivariate analysis, only drug abuse was an independent predictor of new episodes of endocarditis (HR 8.5, p 〈 0.001). Echocardiographic follow-up, available in 95 cases, showed a worsening of left ventricular systolic function ( p 〈 0.007); severe valvular dysfunction at follow-up was reported only in 4 patients, all of them had mitral IE ( p 〈 0.03). Conclusions The present study highlights some clinical, readily available factors that can be useful to stratify the prognosis of patients with IE.
Type of Medium:
Online Resource
ISSN:
1471-2261
DOI:
10.1186/s12872-021-01853-6
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2021
detail.hit.zdb_id:
2059859-2
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