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Invasive Procedures Associated With the Development of Infective Endocarditis
Imre Janszky1, Katalin Gémes2, Staffan Ahnve2
1Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway; Regional Center for Health Care Improvement, St. Olavs Hospital, Trondheim, Norway.
Journal of the American College of Cardiology
|June 16, 2018
Summary
Invasive medical procedures, including cardiovascular surgery and dialysis, significantly increase the risk of developing infective endocarditis. This nationwide study highlights the need for caution with certain medical interventions.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Invasive medical procedures can lead to bacteremia, potentially triggering infective endocarditis.
- Empirical data on the human risk of infective endocarditis following invasive procedures is limited.
- The actual risk posed by medical procedures for endocarditis remains debated.
Purpose of the Study:
- To quantify the excess risk of infective endocarditis associated with invasive medical and surgical procedures.
- To provide empirical data on the link between procedures and endocarditis.
- To inform clinical practice regarding procedural risks.
Main Methods:
- Nationwide case-crossover study in Sweden (1998-2011).
- Identified 7,013 adult patients with infective endocarditis.
- Compared invasive nondental procedures in the 12 weeks before endocarditis versus a baseline period one year prior, excluding procedures related to existing sepsis or endocarditis.
Main Results:
- Several procedures were strongly associated with increased infective endocarditis risk.
- Notable procedures include cardiovascular procedures (e.g., coronary artery bypass grafting), skin procedures, wound management, transfusions, dialysis, bone marrow puncture, and bronchoscopy.
Conclusions:
- Certain invasive nondental medical procedures are linked to a substantially elevated risk of infective endocarditis.
- Findings suggest a significant procedural risk that warrants consideration in patient management.
- Further research may explore specific risk mitigation strategies.
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