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Changing profile of infective endocarditis during 31-year time course in a tertiary care hospital

Year 2022, Volume: 4 Issue: 2, 146 - 151, 29.03.2022
https://doi.org/10.38053/acmj.1053785

Abstract

Aim: Infective endocarditis (IE), infection of the endocardial surface of heart, may cause mortality up to 30% despite advancements in medical care. Epidemiology of IE and profile of causative organism has changed in the last years. We aimed to investigate the changing profile of IE over a 31-year period in a tertiary care hospital
Material and Method: Medical records of 290 patients treated with the diagnosis of IE between 1974 and 2005 were re-evaluated according to Modified Duke criteria. Forty seven cases were classified as rejected cases.
Results: Of the 243 patients 109 was female (44.8%) and 134 male (55.2%). The mean age of the patients was 38±16.4 years (Table). The mean age of the patients showed an increasing trend throughout the time (p< 0.001) ; it was 29 years between 1974- 1980 but increased to 54 years in 2001-2005 period. Rheumatic valvular disease (RVD) was the most frequent underlying heart disease (60%) but showed a declining trend especially in the last years. S. aureus was the most common pathogen in all the time periods (15.2%). Blood cultures were negative in 90 (43%) patients. But the percentage of blood culture negativitiy decreased significantly from 63% in 1981-1985 periods to 28% in 2001-2005 period. (p: 002). Mitral valve was the most common affected valve (52, 44%). Surgery was performed in 74 of the 243 cases (30.5%). In-hospital mortality rate was 30.6. Mortality rate was significantly lower in patients who underwent surgery compared to ones who did not (19.2% vs. 35.8%, p< 0.005). Mortality rate was also lower in patients with community acquired infection compared to ones with nosocomial infection (27% vs 45%). Embolic events, nosocomial infections and surgery were independent risk factors for mortality.
Conclusion: The mean age of IE population is increasing, RVD disesase is less commonly seen as an underlying heart and S. aureus is the most common pathogen. These findings are compatible with the reports from developed countries. Surgery displays a protective effect on the prognosis of IE

Supporting Institution

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Project Number

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References

  • Mostaghim AS, Lo HYA, Khardori N. A retrospective epidemiologic study to define risk factors, microbiology, and clinical outcomes of infective endocarditis in a large tertiary-care teaching hospital. SAGE Open Med 2017; 5: 2050312117741772.
  • Rajani R, Klein JL. Infective endocarditis: A contemporary update. Clin Med (Lond) 2020; 20: 31-5.
  • Hubers SA, DeSimone DC, Gersh BJ, Anavekar NS. Infective endocarditis: a contemporary review. Mayo Clin Proc 2020; 95: 982-97.
  • Yilmaz Ak H, Özşahin Y, Yesiltas MA, et al. Comparison of demographic profile, laboratory, epidemiology and clinical outcomes in patients with native valve and prosthetic valve endocarditis. Heart Surg Forum 2021; 24: E534-43.
  • Selton-Suty C, Célard M, Le Moing V, et al. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey. Clin Infect Dis 2012; 54: 1230-9.
  • Leblebicioglu H, Yilmaz H, Tasova Y, et al. Characteristics and analysis of risk factors for mortality in infective endocarditis. Eur J Epidemiol 2006; 21: 25-31.
  • Zencirkiran Agus H, Kahraman S, Arslan C, et al. Characterization, epidemiological profile and risk factors for clinical outcome of infective endocarditis from a tertiary care centre in Turkey. Infect Dis (Lond) 2019; 51: 738-44.
  • Vahabi A, Gül F, Garakhanova S, Sipahi H, Sipahi OR. Pooled analysis of 1270 infective endocarditis cases in Turkey. J Infect Dev Ctries 2019; 13: 93-100.
  • Baddour LM, Wilson WR, Bayer AS, et al. Infective Endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation 2015; 132: 1435-86.
  • Habib G, Lancellotti P, Antunes MJ, et al. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). G Ital Cardiol (Rome) 2016: 17: 277-319.
  • Şimşek-Yavuz S, Akar AR, Aydoğdu S, et al. Diagnosis, treatment and prevention of infective endocarditis: Turkish consensus report-2019. Turk Kardiyol Dern Ars 2020; 48: 187-226.
  • Correa de Sa DD, Tleyjeh IM, Anavekar NS, et al. Epidemiological trends of infective endocarditis: a population-based study in Olmsted County, Minnesota. Mayo Clin Proc 2010; 85: 422-6.
  • Ilhão Moreira R, Coutinho Cruz M, Moura Branco L, et al. Infective endocarditis: Surgical management and prognostic predictors. Rev Port Cardiol (Engl Ed) 2018; 37: 387-94.
  • Ferraris L, Milazzo L, Rimoldi SG, et al. Epidemiological trends of infective endocarditis in a single center in Italy between 2003-2015. Infect Dis (Lond) 2018; 50: 749-56.
Year 2022, Volume: 4 Issue: 2, 146 - 151, 29.03.2022
https://doi.org/10.38053/acmj.1053785

Abstract

Project Number

None

References

  • Mostaghim AS, Lo HYA, Khardori N. A retrospective epidemiologic study to define risk factors, microbiology, and clinical outcomes of infective endocarditis in a large tertiary-care teaching hospital. SAGE Open Med 2017; 5: 2050312117741772.
  • Rajani R, Klein JL. Infective endocarditis: A contemporary update. Clin Med (Lond) 2020; 20: 31-5.
  • Hubers SA, DeSimone DC, Gersh BJ, Anavekar NS. Infective endocarditis: a contemporary review. Mayo Clin Proc 2020; 95: 982-97.
  • Yilmaz Ak H, Özşahin Y, Yesiltas MA, et al. Comparison of demographic profile, laboratory, epidemiology and clinical outcomes in patients with native valve and prosthetic valve endocarditis. Heart Surg Forum 2021; 24: E534-43.
  • Selton-Suty C, Célard M, Le Moing V, et al. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey. Clin Infect Dis 2012; 54: 1230-9.
  • Leblebicioglu H, Yilmaz H, Tasova Y, et al. Characteristics and analysis of risk factors for mortality in infective endocarditis. Eur J Epidemiol 2006; 21: 25-31.
  • Zencirkiran Agus H, Kahraman S, Arslan C, et al. Characterization, epidemiological profile and risk factors for clinical outcome of infective endocarditis from a tertiary care centre in Turkey. Infect Dis (Lond) 2019; 51: 738-44.
  • Vahabi A, Gül F, Garakhanova S, Sipahi H, Sipahi OR. Pooled analysis of 1270 infective endocarditis cases in Turkey. J Infect Dev Ctries 2019; 13: 93-100.
  • Baddour LM, Wilson WR, Bayer AS, et al. Infective Endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation 2015; 132: 1435-86.
  • Habib G, Lancellotti P, Antunes MJ, et al. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). G Ital Cardiol (Rome) 2016: 17: 277-319.
  • Şimşek-Yavuz S, Akar AR, Aydoğdu S, et al. Diagnosis, treatment and prevention of infective endocarditis: Turkish consensus report-2019. Turk Kardiyol Dern Ars 2020; 48: 187-226.
  • Correa de Sa DD, Tleyjeh IM, Anavekar NS, et al. Epidemiological trends of infective endocarditis: a population-based study in Olmsted County, Minnesota. Mayo Clin Proc 2010; 85: 422-6.
  • Ilhão Moreira R, Coutinho Cruz M, Moura Branco L, et al. Infective endocarditis: Surgical management and prognostic predictors. Rev Port Cardiol (Engl Ed) 2018; 37: 387-94.
  • Ferraris L, Milazzo L, Rimoldi SG, et al. Epidemiological trends of infective endocarditis in a single center in Italy between 2003-2015. Infect Dis (Lond) 2018; 50: 749-56.
There are 14 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles
Authors

Ali Erkan Duman 0000-0002-7093-2503

Yesim Cetinkaya Sardan 0000-0001-7119-5237

Project Number None
Early Pub Date March 24, 2022
Publication Date March 29, 2022
Published in Issue Year 2022 Volume: 4 Issue: 2

Cite

AMA Duman AE, Cetinkaya Sardan Y. Changing profile of infective endocarditis during 31-year time course in a tertiary care hospital. Anatolian Curr Med J / ACMJ / acmj. March 2022;4(2):146-151. doi:10.38053/acmj.1053785

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