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Neurological Complications and Clinical Outcomes of Infective Endocarditis
Alvin S Das1, Morgan McKeown2, Stephanie A Jordan2
1Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Kirstein 473, Boston, MA 02215, USA.
Summary
Neurological complications are frequent in infective endocarditis (IE), linked to mitral valve issues and antiplatelet use. Territorial infarcts and encephalopathy significantly worsen patient outcomes.
Area of Science:
- Cardiology
- Neurology
- Infectious Diseases
Background:
- Infective endocarditis (IE) is a serious infection affecting heart valves.
- Neurological complications are a significant concern in IE patients, impacting prognosis.
- Understanding these complications is crucial for improving patient management.
Purpose of the Study:
- To identify clinical features associated with neurological complications in IE.
- To evaluate the impact of these neurological complications on patient outcomes.
- To determine factors influencing unfavorable outcomes and mortality in IE.
Main Methods:
- A case series of 260 infective endocarditis patients from 2015-2019 was analyzed.
- Logistic regression models identified associations with neurological complications and adverse outcomes.
- Variables included demographics, clinical features, and treatment interventions.
Main Results:
- Neurological complications occurred in 63% of IE patients, most commonly septic emboli.
- Antiplatelet usage and mitral valve vegetations were independently associated with neurological complications.
- Territorial infarction and encephalopathy increased the risk of unfavorable outcomes; cardiac surgery reduced risk.
Conclusions:
- Neurological complications are highly prevalent in infective endocarditis.
- Mitral valve endocarditis and antiplatelet use are risk factors for neurological complications.
- Territorial infarcts and encephalopathy are key predictors of poor outcomes in IE patients.
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