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Infective endocarditis: a lethal disease

J A Ormiston, J M Neutze, T M Agnew

    Australian and New Zealand Journal of Medicine
    |December 1, 1981
    PubMed
    Summary
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    Early surgical intervention for infective endocarditis (IE) improves survival, especially in patients with severe heart failure or persistent fever after one week of antibiotics. Prompt surgery is crucial for better outcomes in IE cases.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Cardiac Surgery

    Background:

    • Infective endocarditis (IE) is a serious infection affecting heart valves.
    • Outcomes in IE are influenced by various factors including patient condition and treatment approach.

    Purpose of the Study:

    • To analyze factors affecting outcomes in infective endocarditis.
    • To evaluate the impact of surgical intervention timing on patient survival and recurrence rates.

    Main Methods:

    • Retrospective analysis of 189 IE episodes in 177 patients over 18 years.
    • Correlation of clinical features, cardiac lesions, infecting organisms, and surgical intervention with patient outcomes.

    Main Results:

    • Overall hospital survival was 79%, with a 13-year actuarial survival of 47%.

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  • Patients with severe heart failure had higher survival (69%) with early surgery versus antibiotic completion (40%).
  • Persistent fever after one week of antibiotics indicated higher complication rates (61% infected pannus) and lower survival (53%) compared to afebrile patients (96% survival).

    • Conclusions:

    • Early surgical intervention is associated with improved survival in infective endocarditis, particularly in severe cases.
    • A treatment policy advocating for surgery when infection and heart failure signs persist beyond one week of antibiotic therapy may yield better results.