Naslov
Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study.

Autori
Murdoch, D. R. ; Corey, G. R. ; Hoen, B. ; Mir, J. M. ; Fowler, V. G. Jr. ; Bayer, A. S. ; Karchme, A. W. ; Olaison, L. ; Pappas, P. A. ; Moreillon, P. ; Chambers, S. T. ; Chu, V. H. ; Falcó, V. ; Holland, D. J. ; Jones, P. ; Klein, J. L. ; Raymond, N. J. ; Read, K. M. ; Tripodi, M. F. ; Utili, R. ; Wang, A. ; Woods, C. W. ; Cabell, C. H. ; International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators: Baršić, Bruno et al.

Izvornik
Archives of Internal Medicine (0003-9926) 169 (2009), 5; 463-473

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
endocarditis; hospital mortality

Sažetak
Background: We sought to provide a contemporary picture of the presentation, etiology, and outcome of infective endocarditis (IE) in a large patient cohort from multiple locations worldwide. Methods: Prospective cohort study of 2781 adults with definite IE who were admitted to 58 hospitals in 25 countries from June 1, 2000, through September 1, 2005. Results: The median age of the cohort was 57.9 (interquartile range, 43.2-71.8) years, and 72.1% had native valve IE. Most patients (77.0%) presented early in the disease (<30 days) with few of the classic clinical hallmarks of IE. Recent health care exposure was found in one-quarter of patients. Staphylococcus aureus was the most common pathogen (31.2%). The mitral (41.1%) and aortic (37.6%) valves were infected most commonly. The following complications were common: stroke (16.9%), embolization other than stroke (22.6%), heart failure (32.3%), and intracardiac abscess (14.4%). Surgical therapy was common (48.2%), and in-hospital mortality remained high (17.7%). Prosthetic valve involvement (odds ratio, 1.47 ; 95% confidence interval, 1.13-1.90), increasing age (1.30 ; 1.17-1.46 per 10-year interval), pulmonary edema (1.79 ; 1.39-2.30), S aureus infection (1.54 ; 1.14-2.08), coagulase-negative staphylococcal infection (1.50 ; 1.07-2.10), mitral valve vegetation (1.34 ; 1.06-1.68), and paravalvular complications (2.25 ; 1.64-3.09) were associated with an increased risk of in-hospital death, whereas viridans streptococcal infection (0.52 ; 0.33-0.81) and surgery (0.61 ; 0.44-0.83) were associated with a decreased risk. Conclusions: In the early 21st century, IE is more often an acute disease, characterized by a high rate of S aureus infection. Mortality remains relatively high.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA