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Observational Study
. 2019 Jun 25;16(12):2248.
doi: 10.3390/ijerph16122248.

Diabetes Mellitus: An Independent Risk Factor of In-Hospital Mortality in Patients with Infective Endocarditis in a New Era of Clinical Practice

Cheng-Jei Lin  1   2 , Sarah Chua  3   4 , Sheng-Ying Chung  5   6 , Chi-Ling Hang  7   8 , Tzu-Hsien Tsai  9   10
Affiliations
Observational Study

Diabetes Mellitus: An Independent Risk Factor of In-Hospital Mortality in Patients with Infective Endocarditis in a New Era of Clinical Practice

Cheng-Jei Lin et al. Int J Environ Res Public Health. .

Abstract

Infective endocarditis (IE) is a severe disease with a hospital mortality rate of 17%-25%. Early identification of IE patients with high risk of mortality may improve their clinical outcomes. Patients with diabetes mellitus (DM) who develop infective diseases are associated with worse outcomes. This study aimed to define the impact of DM on long-term mortality in IE patients. A total of 412 patients with definite IE from February 1999 to June 2012 were enrolled in this observational study and divided into 2 groups: group 1, patients with DM (n = 72) and group 2, patients without DM (n = 340). The overall in-hospital mortality rate for both groups combined was 20.2% and was higher in group 1 than in group 2 (41.7% vs. 16.5%, p < 0.01). Compared to patients without DM, patients with DM were older and associated with higher incidence of chronic diseases, less drug abuse, higher creatinine levels, and increased risk of Staphylococcus aureus infection (all p < 0.05). Moreover, they were more likely to have atypical clinical presentation and were associated with longer IE diagnosis time (all p < 0.05). In multivariable analysis, DM is an independent and significant predictor of mortality. The prognosis of IE patients with DM is still poor. Early identification and more aggressive treatment may be considered in IE patients with DM.

Keywords: diabetes mellitus; infective endocarditis; mortality.

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Conflict of interest statement

The authors declare no conflict of interest

Figures

Figure 1
Figure 1
Cohort selection flowchart. The final study cohort included 412 patients diagnosed with definite infective endocarditis according to the modified Duke criteria.
See this image and copyright information in PMC

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