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Prognostic factors in infective endocarditis in general hospitals in the Netherlands

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ABSTRACT

Introduction: Despite advances in treatment, infective endocarditis (IE) still ranks amongst the most lethal infectious diseases. We sought to determine prognostic factors in general hospitals in the Netherlands as research in this setting is scarce.

Results: Between 2004 and 2011, we identified 216 cases of IE, 30.1 % of which were prosthetic valve IE. This leads to an annual incidence of IE of 5.7 new cases per 100,000 persons per year. Women were less likely to undergo surgical intervention (OR = 1.96, 95 % CI 1.06–3.61, p = 0.031). Also, ageing was an independent prognostic factor for not receiving surgery in a multivariate analysis (annual OR = 1.04, 95 % CI 1.02–1.06, p < 0.001). Female sex was a prognostic factor for mortality (OR = 2.35, 95 % CI 1.29–4.28, p = 0.005). Age was also an independent prognostic factor for mortality (OR = 1.05, 95% CI 1.03–1.08, p < 0.001). Conservative treatment was a prognostic factor for mortality (OR = 3.39, 95 % CI 1.80–6.38, p < 0.001) whereas surgical intervention was an independent prognostic factor for adverse events (OR = 3.03, 95% CI 1.64–5.55, p < 0.001). Staphylococcus aureus was an independent prognostic factor for adverse events (OR = 2.05, 95 % CI 1.10–3.84, p = 0.024) but not for mortality.

Conclusion: This study shows that endocarditis in general hospitals has a high rate of morbidity and mortality. Even when treated, it ranks as one of the most lethal infectious diseases in the Netherlands, especially in women and the elderly.

No MeSH data available.


Annual distribution of new IE cases per year
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Fig1: Annual distribution of new IE cases per year

Mentions: Between 2004 and 2011, we identified 216 cases of IE (Fig. 1). Based on the three general hospitals and the per-hospital catchment area, this would amount to an annual incidence of IE of 5.7 new cases per 100,000 persons per year [22, 23]. The mean age at the time of the diagnosis was 67.5 years (22–97). Men were more affected than women: 62.5 % versus 37.5 %. Definite IE was diagnosed in 82.8 % of the patients. Transthoracic echocardiogram confirmed the diagnosis in 19.4 % of the cases and transoesophageal echocardiogram in 74.1 %. In 6.5 % no vegetation was visible. A total of 44 % of the population did not have a predisposing risk factor for IE.Fig. 1


Prognostic factors in infective endocarditis in general hospitals in the Netherlands
Annual distribution of new IE cases per year
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC5120003&req=5

Fig1: Annual distribution of new IE cases per year
Mentions: Between 2004 and 2011, we identified 216 cases of IE (Fig. 1). Based on the three general hospitals and the per-hospital catchment area, this would amount to an annual incidence of IE of 5.7 new cases per 100,000 persons per year [22, 23]. The mean age at the time of the diagnosis was 67.5 years (22–97). Men were more affected than women: 62.5 % versus 37.5 %. Definite IE was diagnosed in 82.8 % of the patients. Transthoracic echocardiogram confirmed the diagnosis in 19.4 % of the cases and transoesophageal echocardiogram in 74.1 %. In 6.5 % no vegetation was visible. A total of 44 % of the population did not have a predisposing risk factor for IE.Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Despite advances in treatment, infective endocarditis (IE) still ranks amongst the most lethal infectious diseases. We sought to determine prognostic factors in general hospitals in the Netherlands as research in this setting is scarce.

Results: Between 2004 and 2011, we identified 216 cases of IE, 30.1 % of which were prosthetic valve IE. This leads to an annual incidence of IE of 5.7 new cases per 100,000 persons per year. Women were less likely to undergo surgical intervention (OR = 1.96, 95 % CI 1.06–3.61, p = 0.031). Also, ageing was an independent prognostic factor for not receiving surgery in a multivariate analysis (annual OR = 1.04, 95 % CI 1.02–1.06, p < 0.001). Female sex was a prognostic factor for mortality (OR = 2.35, 95 % CI 1.29–4.28, p = 0.005). Age was also an independent prognostic factor for mortality (OR = 1.05, 95% CI 1.03–1.08, p < 0.001). Conservative treatment was a prognostic factor for mortality (OR = 3.39, 95 % CI 1.80–6.38, p < 0.001) whereas surgical intervention was an independent prognostic factor for adverse events (OR = 3.03, 95% CI 1.64–5.55, p < 0.001). Staphylococcus aureus was an independent prognostic factor for adverse events (OR = 2.05, 95 % CI 1.10–3.84, p = 0.024) but not for mortality.

Conclusion: This study shows that endocarditis in general hospitals has a high rate of morbidity and mortality. Even when treated, it ranks as one of the most lethal infectious diseases in the Netherlands, especially in women and the elderly.

No MeSH data available.