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Errors in diagnosis of infective endocarditis

H R Naderi1, F Sheybani1, S S Erfani1

  • 1Department of Infectious Diseases,Faculty of Medicine,Mashhad University of Medical Sciences,Mashhad,Iran.

Epidemiology and Infection
|January 10, 2018
PubMed

Insights

Diagnostic discrepancies in infective endocarditis (IE) occurred in over half of patients, significantly increasing poor outcomes. A history of prosthetic valve replacement was linked to accurate initial diagnosis.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Internal Medicine

Background:

  • Infective endocarditis (IE) is a life-threatening infection with significant morbidity and mortality.
  • Early diagnosis and management are crucial but often challenging.
  • Understanding diagnostic obstacles is vital for improving patient outcomes.

Purpose of the Study:

  • To determine the frequency of diagnostic discrepancies in patients with infective endocarditis.
  • To identify factors associated with diagnostic discrepancies.
  • To evaluate the impact of diagnostic discrepancies on patient outcomes.

Main Methods:

  • Retrospective review of hospital records for adult patients diagnosed with IE.
  • Analysis of discrepancies between admission and discharge diagnoses.
  • Multivariate analysis to identify predictors of diagnostic accuracy.

Main Results:

  • Diagnostic discrepancy was observed in 54.2% of 118 IE episodes.
  • Patients with diagnostic discrepancies had more than double the odds of a poor outcome.
  • History of prosthetic valve replacement was the only independent predictor of non-discrepant diagnosis.

Conclusions:

  • Diagnostic discrepancies are common in infective endocarditis and associated with worse outcomes.
  • A comprehensive clinical syndrome approach, including predisposing factors, may improve diagnostic accuracy.
  • Further research into improving early IE diagnosis is warranted.

Keywords:
Diagnostic errorinfective endocarditis

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