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The main predictors of in-hospital mortality in patients with infective endocarditis: a retrospective single-center study
Session:
Posters - F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Speaker:
Bárbara Marques Ferreira
Congress:
CPC 2021
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
16. Infective Endocarditis
Subtheme:
16.2 Infective Endocarditis – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Bárbara Marques Ferreira; Inês Cruz; Ana Marques; Ana Rita Pereira; Alexandra Briosa; João Grade Santos; Sofia Alegria; Daniel Sebaiti; Mariana Martinho; Ana Rita Almeida; Isabel João; Paula Fazendas; Hélder Pereira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Background: Infective endocarditis (IE) is a serious disease with high level of in-hospital morbidity and mortality; it is associated with severe complications including clinical evolution with septic shock and heart failure or presence of local complications. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Purpose: Identify and characterize predictors of in-hospital mortality in IE. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods: Single-center retrospective analysis of patients (pts) with IE admitted during a 14 –year period (2006-2020). Data on past medical history, clinical presentation, epidemiology, isolated microorganisms, echocardiogram and clinical outcomes during hospitalization were evaluated. Results: A total of 222 pts were included, 72.1% males, age: median 66 (IQR 23) years. Infective endocarditis in a prosthetic valve occurred in 24.8%. Staphylococcus aureus was isolated in 27% (60 pts) and negative blood-cultures endocarditis in 18% (40 pts). Using transesophageal echocardiogram (TEE) perianullar complications were diagnosed in 18% (40 pts): isolated abscess in 8.6%, pseudoaneurysm in 8%, fistula in 0,5% and more than one complication in 5,4%. Clinical evolution with heart failure occurred in 34.7% and septic shock in 20.7%. Seventy-five pts (33.8%) underwent surgery. The in-hospital mortality rate was 28.8% (64 pts).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">We performed a logistic regression model to identify the main risk factors for in-hospital mortality which were: Staphylococcus aureus etiology (OR 3.503; 95% CI: 1.422-8.625), negative blood-cultures endocarditis (OR 3.503; 95% CI: 1.237-8.309), clinical evolution with septic shock (OR: 7.715; 95% CI: 3.237-18.384) and clinical evolution with heart failure (OR: 4.923; 95% CI: 2.223-10.903). Age had a minimal influence (OR 1.041; 95% CI: 1.013-1.069). Cardiac surgery was a protective factor for in-hospital mortality (OR: 0.133; 95% CI: 0.046-0.389). Valve type, evidence of valve obstruction or perianullar complications in TEE did not influence in-hospital mortality in this cohort of patients. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion(s): In our population the main risk factors for in-hospital mortality were clinical evolution with heart failure and septic shock, Staphylococcus aureus etiology and negative blood-cultures endocarditis. Surgical correction significantly decreased the in-hospital mortality.</span></span></p>
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