Patients with Infective Endocarditis: Experience of a Single-Center and Tertiary Referral Hospital for Five-Years

Abstract

Objective: Infective endocarditis (IE) is a systemic infection which results from the inner surface of the heart. Due to rarity of disease and absence of data from large randomized clinical trials, recommendations for prevention, diagnosis and treatment of IE are still derived from expert opinion and observational cohort studies. In this study to we aimed to describe the epidemiological and clinical features of IE in a single tertiary-care hospital in Turkey.

Materials and Methods: The records of 61 patients aged ≥18 who were admitted to our cardiology clinic due to IE were investigated retrospectively. Clinical and demographic characteristics of patients, labratory values, microbiological findings, treatment modalities, records of transthoracic echocardiography (TTE), and transesophageal echocardiography (TEE) examinations and hospitalization outcomes were evaluated.

Results: According to our data, serum white blood cell (WBC), sedimantation (ESR), C reactive protein (CRP) and procalcitonin levels were significantly higher in patients who died from IE compared to those who survived (p<0.05). In addition, there was a statistically significant association between in hospital mortality and presence of chronic renal failure and pericardial effussion (p<0.05). Furthermore, presence of valvular regurgitation and large vegetations were more prevalent in patients who died from IE compared to those who survived (p<0.05).

Conclusion: Our data showed that IE has a diverse etiology, various clinical manifestations and often requires different therapeutic approaches. In order to prevent complications, careful assessment and optimal timing of surgery is mandatory.

Keywords

• infective endocarditis
• heart failure
• valvular regurgitation

Enfektif Endokarditli Hastalar: Üçüncü Basamak Tek Merkez Sevk Hastanesinin Beş Yıllık Deneyimi

Öz

Amaç: Enfektif endokardit (EE), kalbin iç yüzeyinden kaynaklanan sistemik bir enfeksiyondur. Hastalığın nadir olması ve büyük randomize klinik çalışmalardan veri bulunmaması nedeniyle, EE'nin önlenmesi, teşhisi ve tedavisi için öneriler hala uzman görüşlerinden ve gözlemsel kohort çalışmalarından elde edilmektedir. Bu çalışmada Türkiye'deki tek bir üçüncü basamak hastanesinde EE'nin epidemiyolojik ve klinik özelliklerini tanımlamayı amaçladık.

Materyal ve Metot: Kardiyoloji kliniğimize EE nedeniyle başvuran 61 (≥18 yaş) hastanın kayıtları geriye dönük olarak incelendi. Hastaların klinik ve demografik özellikleri, laboratuvar değerleri, mikrobiyolojik bulgular, tedavi yöntemleri, transtorasik ekokardiyografi (TTE) kayıtları ve transözofageal ekokardiyografi (TÖE) tetkikleri ve hastanede yatış sonuçları değerlendirildi.

Bulgular: Verilerimize göre EE'den ölen hastalarda, hayatta kalanlara göre serum beyaz kan hücresi (WBC), sedimantasyon (ESR), C reaktif protein (CRP) ve prokalsitonin düzeyleri anlamlı olarak yüksekti (p<0,05). Ek olarak hastane içi mortalite ile kronik böbrek yetmezliği ve perikardiyal efüzyon varlığı arasında istatistiksel olarak anlamlı bir ilişki vardı (p<0,05). Ayrıca, EE'den ölen hastalarda, hayatta kalanlara göre kapak yetersizliği ve büyük vejetasyon varlığı daha yaygındı (p<0,05).

Sonuç: Verilerimiz, EE'nin farklı bir etiyolojiye, çeşitli klinik belirtilere sahip olduğunu ve sıklıkla farklı terapötik yaklaşımlar gerektirdiğini gösterdi. Komplikasyonları önlemek için dikkatli değerlendirme ve en uygun ameliyat zamanlaması çok önemlidir. 

Anahtar Kelimeler

• enfektif endokardit
• kalp kapak yetmezliği
• kalp yetmezliği

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