Hospital mortality predictors of infective endocarditis

Abstract

Background: Infective endocarditis (IE) is a life-threatening disease associated with serious complications, including heart failure, usually because of severe valvular insufficiency, and embolic stroke. Significant changes have been reported in IE epidemiology concerning pathogens and patients’ characteristics. The clinical features of IE have significantly changed as well as the role of pathogens. Despite trends toward earlier diagnosis and surgical intervention, in-hospital mortality rates have not improved over the last three decades. Therefore, the analysis of in-hospital mortality factors becomes important. The purpose of the present study was to determine in-hospital mortality factors among patients with IE in the Department of Cardiology, of our University Clinics in the period 2014-2017. Methods: Retrospective analysis of IE cases (N=135) at our University Clinics Cardiology department during the period 2014-2017. 78 males (57.8 % and 57 females (42.2 %) were investigated. Data collected about IE clinical features, course, complications, pathogens. Package "SPss 19.0" was used in the statistical analysis. Primary, the distribution of the investigated variables (gender, age, IE forms, pathogens, complications) among dead and survivors was evaluated, compared and tested for statistical significance. Secondly, the multifactorial logistic regression analysis was performed to reveal the significant independent in-hospital mortality related factors. Results: Primary IE was defined in 45 patients (33.3%), secondary IE in 90 patients (66.7 %), prosthetic valve IE in 40 patients (30.3 %). When analysing clinical forms of IE, the most common was classical IE clinical form (38.5 %), heart failure form presenting as acute heart failure in 20.0 % cases, pulmonary form in 8.9 % of cases. Septic shock was in 7.4 % of cases, embolic events were determined in 25.9 % of cases, renal failure in 55.6 %, severe heart...[...].