Infective endocarditis in a Sydney teaching hospital--1962-1971

This report represents a comprehensive review of infective endocarditis in a major Australian centre between the years 1962 and 1971. During the later years of this study prosthetic valves were inserted in significant numbers and cardiac surgery became available in the treatment of endocarditis. The following major points emerged. There has been no reduction in the incidence of this disease within the period of study. A higher percentage of cases have followed surgery, particularly cardiac. There has been a decreased number of cases following dental extraction or urological surgery. A change in the pattern of the infective organisms was observed, particularly an increase in Staphylococcal infections, although Strep. viridans was the most frequent infecting agent. Infected prosthetic valves accounted for 11% of cases in the latter five year period, Staphylococcal infections being responsible for the majority of these cases. The mortality for prosthetic infections was 80%, and a loss of anticoagulant control contributed to death in 42% of patients. There was a reduction in mortality due to endocarditis from 39% between 1962 and 1966 to 24% between 1967 and 1971 (P less than 0-05).