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Infective Endocarditis in a Tertiary Hospital in Porto-Is There Anything New?

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Infective endocarditis (IE) in Portugal affects an older population, often with prosthetic material infections. Early surgical decisions and multidisciplinary teams are crucial for improving outcomes in this complex disease.

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Infective endocarditis (IE) presents complex challenges despite diagnostic and therapeutic advancements.
  • An aging population is altering the epidemiological landscape of IE, impacting its clinical presentation and management strategies.
  • This study characterizes IE at a Portuguese tertiary hospital before implementing a multidisciplinary Endocarditis Team.

Purpose of the Study:

  • To describe the epidemiological, clinical, and microbiological features of infective endocarditis (IE).
  • To provide a contemporary overview of IE in Portugal.
  • To underscore the need for specialized management approaches.

Main Methods:

  • Retrospective analysis of adult patients diagnosed with definite or possible IE (2015 ESC criteria) from January 2019 to December 2023.
  • Data collection from electronic medical records, including demographics, comorbidities, microbiology, imaging, and surgical outcomes.
  • Inclusion of 143 IE episodes.

Main Results:

  • The median patient age was 71 years, with 81% of infections related to heterologous materials.
  • Common pathogens included *Enterococcus faecalis*, viridans group streptococci, and coagulase-negative staphylococci.
  • Surgical intervention was indicated in 74% of cases, but 22% did not undergo surgery due to comorbidities, leading to high in-hospital mortality.

Conclusions:

  • The study reveals an elderly, comorbid patient population with a high prevalence of prosthetic valve endocarditis in Portugal.
  • Findings emphasize the necessity of multidisciplinary care and timely surgical evaluation for IE management.
  • The results support the establishment of dedicated Endocarditis Teams in tertiary healthcare settings.