Clinical features and predictors for mortality in patients with infective endocarditis at a university hospital in Taiwan from 1995 to 2003
Journal
Epidemiology and Infection
Journal Volume
134
Journal Issue
3
Pages
589-597
Date Issued
2006
Author(s)
Abstract
The clinical features and microbiological characteristics of 315 patients with definite or possible infective endocarditis (IE) from January 1995 to December 2003 were evaluated. There were 187 males and 128 females with a mean age of 51 years (range, 1 month to 92 years). Ninety-three patients (30%) had a diagnosis of valvular heart disease and 24 (8%) had received prosthetic valve replacement. Blood culture was negative in 62 patients (20%). Staphylococci (91 patients, 32%), including methicillin-susceptible Staphylococcus aureus (15%), methicillin-resistant S. aureus (11%), and coagulase-negative staphylococci (6%), were the most commonly encountered pathogens followed by viridans group streptococci (77 patients, 24%). Eight patients (25%) had various neurological, renal, embolic, and cardiac complications. Patients with neurological complications [odds ratio (OR) 8·175, P <0.001], nosocomial IE (OR 6·661, P<0·001), underlying malignancy (OR 4·993, P<0·001), elevated serum creatinine level (OR 3·132, P=0·001), or elevated WBC count (>15000/mm3) (OR 2·537,P =0·007) were at significantly increased risk of mortality. This study found mortality from IE was associated with several factors, among which neurological complications were the most hazardous. Patients with more than one risk factor had poorer prognosis. These results suggest the need for more aggressive management in patients with IE when multiple risk factors for mortality are identified. ? 2005 Cambridge University Press.
SDGs
Other Subjects
creatinine; meticillin; adult; aged; alpha hemolytic Streptococcus; article; bacterial endocarditis; bacterium detection; blood culture; child; clinical feature; coagulase negative Staphylococcus; controlled study; creatinine blood level; embolism; female; heart disease; heart valve prosthesis; high risk patient; hospital infection; human; infant; kidney disease; kidney dysfunction; leukocyte count; major clinical study; male; malignant neoplastic disease; medical record review; methicillin resistant Staphylococcus aureus; microbiological examination; mortality; multivariate analysis; neurological complication; prediction; prognosis; risk assessment; Staphylococcus; Taiwan; university hospital; valvular heart disease; Adult; Aged; Bacteremia; Bacteria; Endocarditis, Bacterial; Female; Hospitals, University; Humans; Male; Middle Aged; Taiwan; Time Factors
Type
journal article