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[Infective endocarditis : In-hospital mortality predictive factors]
Othmani Safia1, Jendoubi Asma1, Hedhli Hana1
1Service des urgences, hôpital Charles Nicolle, boulevard 9 Avril 1938 bab saadoun ; 1006 Tunis, Tunisie; Faculté de médecine de Tunis, université Tunis El Manar, Tunisie.
Insights
Infective endocarditis (IE) poses a significant mortality risk. Acute heart failure and cerebral embolism are key predictors of in-hospital death in IE patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Context:
- Infective endocarditis (IE) is a severe condition with high morbidity and mortality.
- Despite advances, predicting outcomes in IE remains challenging.
- Understanding risk factors is crucial for patient management.
Purpose:
- To identify predictive factors for in-hospital mortality in patients with infective endocarditis.
- To analyze the association between clinical presentation, complications, and mortality.
- To inform clinical decision-making and improve patient prognosis.
Summary:
- A prospective study included 34 patients diagnosed with IE using modified Duke criteria.
- The primary risk factor was drug addiction (56%), with tricuspid valve involvement (50%) and Staphylococcus aureus (65%) being common.
- In-hospital mortality was 47%, with acute heart failure and cerebral embolic localization identified as significant predictors.
Impact:
- Identified acute heart failure and cerebral embolic localization as critical determinants of IE mortality.
- Highlights the need for multidisciplinary collaboration for enhanced diagnostic and therapeutic strategies.
- Findings can guide targeted interventions to improve outcomes for high-risk IE patients.
Introduction:
Infective endocarditis (IE) remains a serious disease with significant morbidity and mortality despite therapeutic advancements. The aim of our study was to determine the predictive factors of in-hospital mortality.
Patients And Methods:
A prospective comparative study over a period of 54 months was conducted, including all patients admitted for definite infective endocarditis, diagnosed according to the modified Duke criteria published in 2015 by the European Society of Cardiology.
Results:
Thirty-four patients were included. Drug addiction was the main risk factor for infective endocarditis (56%). Tricuspid valve involvement was predominant (50%). Staphylococcus aureus was the most commonly isolated pathogen (65%). In-hospital mortality rate was 47%. In multivariate analysis, predictive factors for mortality were acute heart failure (OR=7.4; p=0.026; 95% CI [1.2-44]) and cerebral embolic localization (OR=11.1; p=0.024; 95% CI [13-90]).
Conclusions:
Cardiac and cerebral complications influence the prognosis of IE. Thus, close collaboration among multidisciplinary teams is necessary for improved diagnostic and therapeutic management.
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