engleski

Outcome of patients with infective endocarditis

Objectives: To assess risk factors for early lethal outcome in patients with infective endocarditis. Design: Cohort study Setting: Intensive care unit of a university hospital for infectious diseases. Patients: 100 patients with infective endocarditis according to the Duke criteria Interventions: None. Measurements and results: The following variables were evaluated: a) general patient’ s characteristics such as age, gender, chronic diseases, predisposition for IE ; b) clinical presentation (subacute and acute, severe sepsis with multiple organ dysfunction and/or shock), duration of illness until hospitalisation, length of fever (>37.5&ordm ; ; C) after the start of appropriate antimicrobial therapy, type of affected valve, localisation, specification of major and minor Duke criteria ; c) complications such as central nervous affection, cardiac failure ; d) interventions (antibiotics, timing of appropriate antimicrobial therapy, need for mechanical ventilation, surgical procedure) ; e) outcome. Twenty-four of 100 patients died during hospitalisation. Univariate analysis identified severity of sepsis, presence of MODS, respiratory failure requiring mechanical ventilation, development of cardiac failure, S. aureus infecvtion, absence of vegetations and CNS complications as factors associated with increased risk of death. The multivariate forward stepwise logistic regression analysis identified respiratory failure needing mechanical ventilation (p=0, 00006) and cardiac failure (p=0.02) as significant independent predictors of death. Conclusions: Multiorgan dysfunction syndrome, particularly acute respiratory failure needing mechanical ventilation as well as cardiac failure significantly increases risk of death in patients with infective endocarditis.

endocarditis; respiratory failure; Staphylococcus aureus; mechanical ventilation; meningitis; cardiac failure; mortality

nije evidentirano