Outcome and prognostic factors on 57 cases of infective endocarditis in a single centre

We aim to evaluate the clinical characteristics and outcome of infective endocarditis in our hospital, and the prognostic significance of recurrent endocarditis.

A single centre retrospective review of all cases of infective endocarditis (IE) was undertaken for a 5-year period from June 2002.

There were 57 episodes of IE in 47 patients. Seventy percent were definite IE using the modified Duke Criteria (2000). The most commonly isolated organisms were Streptococci (37%) and Staphylococcus aureus (35%). Forty-nine percent of patients remained event-free from death, recurrence, or operation at the end of follow-up period. Five cases (8.5%) had early recurrence of endocarditis within 60 days. Eleven patients (23%) died during follow-up (mean 14 months). There was no significant increase in mortality of patients with history of recurrent endocarditis (38% vs 28%; p=0.39). Staphylococcus aureus was associated with increased mortality or need for valve surgery (OR 4.5; 95%CI 1.38-14.8), risk of neurological events (OR 8.9; 1.5-52), renal failure (OR 7.2; 1.7-30) and thrombocytopenia (OR 5.6; 1.4-22).

The mortality of IE remains high. Less than half of this cohort remained event-free. The micro-organism involved is more predictive of mortality or need for surgery than recurrent endocarditis.