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[Profile of patients with infective endocarditis admitted to a Chilean regional hospital]
Benjamín Stockins1, Víctor Neira, Alejandro Paredes
1Universidad de La Frontera, Temuco, Chile.
Insights
Infective endocarditis (IE) in Chile has a high mortality rate, with 27% of patients dying. Most patients were admitted in critical condition, highlighting the severity of this heart infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Internal Medicine
Context:
- Mortality due to infective endocarditis (IE) in Chile is approximately 30%.
- This study focuses on IE patient experience in a regional tertiary hospital.
- Understanding IE epidemiology and outcomes is crucial for public health.
Purpose:
- To describe the clinical characteristics and outcomes of patients diagnosed with IE.
- To analyze demographic data, severity scores, bacteriology, and hospital evolution.
- To provide insights into the management and prognosis of IE in a Chilean tertiary care setting.
Summary:
- A retrospective study analyzed 107 patients with IE (2003-2010).
- Native valves were most commonly affected (91%), with S. viridans and S. aureus as frequent pathogens.
- High rates of complications (renal, heart, neurological deterioration, systemic embolism) and mortality (27%) were observed.
Impact:
- The findings underscore the significant burden of IE in Chile, with high mortality.
- Most patients presented with severe illness, requiring intensive care and often surgical intervention.
- This data can inform strategies for early diagnosis and improved management of infective endocarditis.
Background:
Mortality due to infective endocarditis (IE) in Chile is close to 30%.
Aim:
To report the experience with patients admitted with the diagnosis of IE in a regional tertiary hospital.
Material And Methods:
Retrospective study of 107 patients aged 50 ± 16 years (75% males) discharged with a definitive diagnosis of IE according to modified DUKE criteria, between years 2003 and 2010. Demographic variables, severity scores, clinical characteristics, bacteriology and hospital evolution were recorded.
Results:
Fifty nine percent of patients had concomitant cardiovascular problems. APACHE II and Sequential Organ Failure Assessment (SOFA) scores on admission were 8.4 ± 4.7 and 2.7 ± 2.8 respectively. Native valves were affected in 91% of cases (aortic and mitral valves in 62% and 50% of cases respectively). Prosthetic valves were affected in 9.3% of cases. Rheumatic heart disease was the predominant primary lesion in 10% of patients. Antibiotics were used in 45.1% before blood cultures were performed. In 68% of patients blood cultures were positive. S. viridans (30.8%), S.aureus (18.6%) and coagulase negative Streptococci (5.6%) were the identified microorganisms. Intensive care unit admission was required in 48% of patients. Renal, heart and neurological deterioration was observed in 53, 34 and 14% of patients, respectively. Twenty percent of patients developed systemic embolism and 37% required heart surgery. Mean hospital stay was 28.3 ± 19.1 days and 27% of patients died.
Conclusions:
In this series of patients, IE has a high mortality. Most patients studied were admitted in bad conditions.
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