Predictors of mortality and adverse events in patients with infective endocarditis: a retrospective real world study in a surgical centre

被引：33

作者：

Scheggi, Valentina ^{[1
,2
]}

Merilli, Irene ^{[1
,2
]}

Marcucci, Rossella ^{[2
,3
]}

Del Pace, Stefano ^{[2
,3
]}

Olivotto, Iacopo ^{[2
,3
]}

Zoppetti, Nicola ^{[5
]}

Ceschia, Nicole ^{[2
,3
]}

Andrei, Valentina ^{[2
,3
]}

Alterini, Bruno ^{[1
,2
]}

Stefano, Pier Luigi ^{[2
,4
]}

Marchionni, Niccolo ^{[2
,3
]}

机构：

[1] Azienda Osped Univ Careggi, Div Cardiovasc & Perioperat Med, Cardiothoracovasc Dept, Largo Brambilla 3, I-50143 Florence, Italy

[2] Univ Florence, Largo Brambilla 3, I-50143 Florence, Italy

[3] Azienda Osped Univ Careggi, Div Gen Cardiol, Cardiothoracovasc Dept, Florence, Italy

[4] Azienda Osped Univ Careggi, Div Cardiac Surg, Cardiothoracovasc Dept, Florence, Italy

[5] CNR, Inst Appl Phys Nello Carrara IFAC, Sesto Fiorentino, Italy

来源：

BMC CARDIOVASCULAR DISORDERS | 2021年 / 21卷 / 01期

关键词：

Infective endocarditis; Prognostic factors; Outcome; Valvular dysfunction; Endocarditis; Mortality; Prognosis; CHALLENGES;

D O I：

10.1186/s12872-021-01853-6

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Purpose 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.

引用

页数：9

共 31 条

[1] Comparison of prognoses of Staphylococcus aureus left-sided prosthetic endocarditis and prosthetic endocarditis caused by other pathogens [J].