Home Bratislava Medical Journal 2019 Bratislava Medical Journal Vol.120, No.7, p.510–515, 2019

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Published Monthly, in English
Founded: 1919
ISSN 0006-9248
(E)ISSN 1336-0345
 

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Bratislava Medical Journal Vol.120, No.7, p.510–515, 2019

Title: Clinical predictors of complications in patients with left–sided infective endocarditis: A retrospective study of 206 episodes
Author: M. Pazdernik, P. Wohlfahrt, J. Kautzner, J. Kettner, J. Sochman, J. Stasek, M. Solar, R. Pelouch, J. Vojacek

Abstract: PURPOSE: Early identification of specific patient subgroups at high risk of developing life–threatening infective endocarditis (IE) complications is of paramount importance. Better stratification may allow more intensive treatment of these patients and positively influences clinical outcomes.
METHODS: We carried out a retrospective survey of consecutive left–sided IE adult patients, admitted over a 15–year period to two main tertiary care centres in the Czech Republic.
RESULTS: Among a group of 196 patients (155 males; median age 64 years), a total of 206 left–sided IE episodes were identified. Perivalvular extension of infection was most frequently seen in prosthetic aortic valve endocarditis (OR 6.706, p<0.0001). Valve prolapse/perforation during IE episodes was significantly associated with mitral valve IE (OR 2.136, p=0.026) and vegetation length (OR 1.055, p=0.009). Septic shock was significantly related to two main risk factors: S. aureus infection (OR 8.459, p=<0.0001) and smoking (OR 8.403, p=0.001). Mitral valve IE with a vegetation length ≥13 mm was the strongest risk factor for this complication (OR 3.24, p=0.001), followed by S. aureus infection (OR 3.59, p=0.002). Finally, septic shock (OR 6.000, p=0.001) represented the most important risk factor of in–hospital mortality.
CONCLUSIONS: This study provides the most detailed profile of complication predictors related to left–sided IE in Central Europe. Early individual stratification of IE related occurrence of complications might help to decrease extremely high morbidity and mortality of this disease (Tab. 5, Ref. 37).

Keywords: infective endocarditis, Staphylococcus aureus, complications of infective endocarditis, mortality
Published online: 12-Jul-2019
Year: 2019, Volume: 120, Issue: 7 Page From: 510, Page To: 515
doi:10.4149/BLL_2019_082


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