Related Experiment Videos
Infective endocarditis in the 1980s: experience at a heart hospital
A J Mansur1, M Grinberg, G Bellotti
1Instituto do Coração, Hospital das Clínicas da FMUSP, São Paulo, Brazil.
Abstract:
Three hundred episodes of infective endocarditis (IE) in 287 patients were studied from October 1978 to August 1986. The patients were in the age range of 0.2-78 (mean 30.76 +/- 16.06) years; 185 (68%) occurred in male patients. The etiologic agents were: Streptococci viridans group (93), enterococci (21), streptococci D group, nonenterococci (19), other streptococci (14), Staphylococcus aureus (59), Staphylococcus epidermidis (14), gram-negative bacteria (16), other gram-positive bacteria (16), fungi (4). Etiologic agents were not isolated in 52 (negative cultures). Valvular heart diseases occurred in 231 episodes, congenital heart diseases in 37, other heart diseases in 6. Sixty-nine occurred in patients with prosthetic heart valves. In 69 there was no previous heart disease. Surgical treatment was performed in 102 episodes (37 with prosthetic valve IE and 65 with native valve IE); 22 patients (21%) died, 12 with prosthetic valve and 10 with native valve IE. The in-hospital mortality (medical and surgical patients) was 26% (78 patients). Long-term follow-up of 206 patients up to 7.1 (mean 2.13 +/- 1.68) years revealed that 26 patients died. Thus, IE remains a disease with high mortality and is fatal to a third of the patients, in spite of the progress in therapeutic methods. Its morbidity and mortality continues beyond the microbiological cure.
Insights
Infective endocarditis (IE) remains a serious condition with high mortality, affecting a third of patients despite advances in treatment. This study highlights the persistent risks and outcomes associated with IE.
Area of Science:
- Cardiology
- Infectious Diseases
- Clinical Medicine
Background:
- Infective endocarditis (IE) is a severe infection of the heart's inner lining, often affecting heart valves.
- Despite therapeutic advancements, IE continues to pose significant mortality risks.
Purpose of the Study:
- To analyze the epidemiological characteristics, etiologic agents, and outcomes of infective endocarditis.
- To evaluate the impact of surgical treatment and prosthetic valves on IE mortality.
Main Methods:
- Retrospective study of 300 IE episodes in 287 patients from 1978 to 1986.
- Analysis of patient demographics, causative microorganisms, heart conditions, treatment modalities, and mortality rates.
Main Results:
- Streptococci and Staphylococcus aureus were the most common etiologic agents.
- Valvular heart disease was the most frequent underlying condition.
- In-hospital mortality was 26%, with a long-term mortality of 33% among survivors.
Conclusions:
- Infective endocarditis continues to be a disease with high morbidity and mortality.
- Mortality risks persist even after microbiological cure, underscoring the need for comprehensive management strategies.