Author + information
- Fabio Chirilloa,b,
- Federica Calabro'a,b,
- Alessandro De Leoa,b,
- Alessandra Pedroccoa,b,
- Francesco Tonaa,b,
- Federica Mondina,b,
- Giuseppe Minnitia,b,
- Piergiorgio Scottona,b and
- Zoran Olivaria,b
Background: In the last decades the clinical and epidemiological profile of infective endocarditis (IE) has considerably changed. The aim of this study is to assess the temporal variations of IE and to identify factors related to in-hospital mortality in a large cohort of patients observed over a 26-year period.
Methods: A retrospective analysis was performed on 703 patients with IE (according to the modified Duke criteria) admitted to Ca’ Foncello Hospital Treviso (Italy) from January 1990 to December 2015.
Results: The median age of the cohort was 63±15 years; 494 patients were male (70%), and 347 (49%) were referred from other hospitals. In order to analyze temporal changing of IE over a 26-year period, we divided patients into three groups (1990-1997, 1998-2006, 2007-2015). Significant variations were observed for the following parameters: median age (57 to 66 years, p<0.0001), rate of referred patients (39.6% to 53%, p=0.04), predisposing conditions and co-morbidity (37.5% to 56.6%, p<0.0001), prosthetic valve IE (8.3% to 31.1%, <0.0001), IE on electronic device (2.1% to 8.1%, p=0.03), infections caused by non-viridans Streptococci (39.6% to 16.9%, p<0.0001), by S. aureus (17.7%, 28.8% and 15.8% respectively in the 3 groups, p=0.001), and by Enterococci (1.5% to 15.8%, p<0.0001), embolic events (32.3%, 26.1% and 36.4%, respectively in the 3 groups, p=0.04), surgery during active phase of IE (24% to 46.2%, p<0.0001), in-hospital mortality (20.8% to 10.7%, p<0.0001). Factors independently associated with in-hospital mortality resulted: prosthetic mitral valve IE (p=0.01), left ventricle ejection fraction < 0.40 (p=0.01), perivalvular abscess (p<0.007), heart failure (p=0.03), uncontrolled infection (p<0.0001), multi-organ failure (p<0.0001) and admission during the earliest period (1990-1997) (p<0.001).
Conclusions: To our knowledge this is the largest single-center cohort of patients with IE reported in the literature. Many relevant variations have occurred in the clinical and epidemiological profile over years: although progress in diagnosis and therapy has significantly contributed to reduced in-hospital mortality the outcome of patients with IE remains poor.
Moderated Poster Contributions
Valvular Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Sunday, March 19, 2017, 12:45 p.m.-12:55 p.m.
Session Title: Infectious Endocarditis: Comprehensive Perspectives
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1313M-05
- 2017 American College of Cardiology Foundation