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. 2002 Jul;88(1):53-60.
doi: 10.1136/heart.88.1.53.

Mortality from infective endocarditis: clinical predictors of outcome

S M Wallace  1 , B I Walton, R K Kharbanda, R Hardy, A P Wilson, R H Swanton
Affiliations

Mortality from infective endocarditis: clinical predictors of outcome

S M Wallace et al. Heart. 2002 Jul.

Abstract

Objective: To identify clinical markers available within the first 48 hours of admission that are associated with poor outcome in infective endocarditis.

Designs: Retrospective cohort study.

Setting: Teaching hospital.

Patients: 208 of 220 patients with infective endocarditis.

Methods: Consecutive patients with infective endocarditis presenting between 1981 and 1999 to a tertiary centre were studied. Clinical, echocardiographic, and haematological data recorded within 48 hours of admission were obtained. Data were analysed using logistic regression models.

Main outcomes measures: Mortality at discharge and at six months.

Results: Data were obtained for 93% of patients who were eligible for inclusion. 194 (93%) were positive for Duke criteria. Mean age was 52 (1.2) years, and 138 (66%) were men. 82 (39%) were transferred from other hospitals. 181 (87%) were blood culture positive, and 47 (23%) infections were Staphylococcus aureus. The infection was located on aortic (n = 85, 41%), mitral (n = 77, 37%), tricuspid (n = 18, 9%), and multiple valves (n = 20, 10%). 67 (32%) had prosthetic valve endocarditis. 48% of the cohort were managed with antibiotics alone. Mortality at discharge was 18% and at six months 27%. Duration of illness before admission, age, sex, valve infected, infecting organism, and left ventricular function were not predictors of adverse mortality. However, abnormal white cell count, serum albumin concentration, serum creatinine concentration, or cardiac rhythm, the presence of two major Duke criteria, or visible vegetation conferred a poor prognosis.

Conclusions: Conventional prognostic factors in this study did not appear to predict outcome early during hospital admission. However, simple clinical indices, which are readily available, are reliable, cheap, and potentially powerful predictors of poor outcome.

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Figures

Figure 1
Figure 1
Comparison between in-hospital and six month mortality.
Figure 2
Figure 2
In-hospital and six month mortality analysed by decades.
Figure 3
Figure 3
Comparison between in-hospital and six month mortality in patients admitted directly to University College London Hospitals (UCLH) and referred patients.
See this image and copyright information in PMC

References

    1. Bayer AS, Bolger AF, Taubert KA, et al. Diagnosis and management of infective endocarditis and its complications. Circulation 1998;98:2936–48. - PubMed
    1. Mansur AJ, Grinberg M, Cardoso RH, et al. Determinants of prognosis in 300 episodes of infective endocarditis. Thorac Cardiovasc Surg 1996;44:2–10. - PubMed
    1. Netzer RO, Zollinger E, Seiler C, et al. Infective endocarditis: clinical spectrum, presentation and outcome: an analysis of 212 cases 1980–1995. Heart 2000;84:25–30. - PMC - PubMed
    1. Weng MC, Chang FY, Young TG, et al. Analysis of 109 cases of infective endocarditis in a tertiary care hospital. Zhonghua Yi Xue Za Zhi (Taipei) 1996;58:18–23. - PubMed
    1. Olaison L, Hogevik H, Myken P, et al. Early surgery in infective endocarditis. Q J Med 1996;89:267–78. - PubMed

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