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Evaluation of Infective Endocarditis in Children: A 19-Year Retrospective Study in Taiwan

Shao-Ju Chien1,2,3, Yi-Ju Tseng4, Ying-Hua Huang1

  • 1Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan.

Journal of Clinical Medicine
|March 29, 2023
PubMed

Insights

Pediatric infective endocarditis (IE) presents differently in children with and without heart disease. While those with heart disease had more complications, their in-hospital mortality was lower, with thrombocytopenia being a key risk factor.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Clinical Outcomes Research

Background:

  • Infective endocarditis (IE) significantly impacts pediatric morbidity and mortality, particularly in those with congenital heart disease.
  • Limited research exists on the differential presentation and outcomes of IE in children with and without underlying heart conditions.

Purpose of the Study:

  • To compare the clinical characteristics and outcomes of pediatric patients with IE, stratified by the presence or absence of heart disease.
  • To identify risk factors associated with in-hospital mortality in pediatric IE.

Main Methods:

  • Retrospective analysis of a large, multi-institutional electronic medical record database (Chang Gung Research Database) in Taiwan from 2001 to 2019.
  • Inclusion of pediatric patients (0-20 years) diagnosed with IE.
  • Extraction and analysis of demographic, clinical features, microbiological data, complications, and outcomes.

Main Results:

  • Of 208 IE patients, 114 had heart disease and 94 did not. Patients with heart disease showed higher rates of streptococcal infections (19.3% vs. 2.1%) and cardiac complications (29.8% vs. 6.4%).
  • Despite more frequent valve surgery (43.9% vs. 8.5%) and longer hospital stays (28.5 vs. 12.5 days) in the heart disease group, their in-hospital mortality was significantly lower (3.5% vs. 10.6%).
  • Thrombocytopenia was identified as an independent risk factor for in-hospital mortality (OR = 6.56).

Conclusions:

  • Microbiological and clinical presentations of IE in pediatric patients vary based on the presence of underlying heart disease.
  • Platelet count serves as a potential risk factor for predicting in-hospital mortality in pediatric IE cases.
Abstract

Keywords:
heart diseasesinfective endocarditispediatricsprognosis

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