IN-HOSPITAL OUTCOME OF PATIENTS WITH INFECTIVE ENDOCARDITIS: A RETROSPECTIVE ANALYSIS
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Abstract
OBJECTIVE: To determine the in-hospital outcome of infective endocarditis (IE) in terms of morbidity, mortality and success of treatment in our set up.
METHODS: This descriptive retrospective study was conducted at Cardiology Unit, Lady Reading Hospital, Peshawar. Records of patients with definite diagnosis of IE from September 2009 to August 2012 were reviewed for complications and treatment outcome during hospital stay. Data was analyzed statistically by using SPSS version 16.
RESULTS: Out of 34 admitted patients, 24 (70.59%) were males and 10 (29.41%) were females with male to female ratio of 2.4:1. Age ranged from 5-38 years with mean age of 26±11 years. Out of 17 complications developed in 14 (41.2%) patients, congestive heart failure (n=7 20.59%), transient ischemic attack (n=3; 8.8%), stroke (n=2 5.88%) and renal failure (n=2 5.88%) were the most frequent complications. Medical treatment failed in 9(26.4%) patients. Mortality rate was 23.5% (n=8/34). Six patients died during medical management and 2 during surgery for IE. Two out of three patients with prosthetic valve died during course of therapy.
CONCLUSION: Morbidity, mortality and failure of medical treatment in admitted cases of infective endocarditis is still high in our set up. Failure of medical treatment is still present in a sizeable proportion. Outcome was found excellent in native valve but poor in prosthetic valve. Surgery though less frequently performed; carries more than 50% mortality.
KEY WORDS: Infective Endocarditis (MeSH), Patient Outcome Assessment (MeSH,Mortality (MeSH), Complications (MeSH).
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References
Ako J, Ikari Y, Hatori M, Hara K, Ouchi
Y. Changing spectrum of infective
endocarditis: Review of 194 episodes
over 20 years. Circ J 2003; 67: 3-7.
Tariq M, Siddiqui BK, Jadoon A, Alam M,
Khan SA, Atiq M, et al. Clinical profile
and outcome of infective endocarditis
at the Aga Khan University Hospital. Int
J Collab Res Internal Med Public Health
; 1: 84-99.
Bayer AS, Bolger AF, Taubert KA,Wilson
W, Steckelberg J, Karchmer AW, et al.
Diagnosis and management of infective
endocarditis and its complications.
Circulation 1998; 98(25): 2936-43.
Bonow RO, Carabello B, Chatterjee K,
de Leon AC Jr, Faxon DP, Freed MD et al:
focused update incorporated into
the ACC/AHA 2006 Practice guidelines
for the management of patients with
valvular heart disease. Circulation 2008;
: 523-29.
Miller B, Moor JE. Antibiotic prophylaxis,
body piercing and infective endocarditis. J
Antimicrob Chemother 2004; 53: 123-26.
Tariq M, Alam M, Munir G, Khan MA,
Smeqo RA. Infective endocarditis: a
five-year experience at a tertiary care
hospital in Pakistan. Int J Infect Dis 2004;
(8): 163-70.
Nunes MC, Gelape CL, Ferrari TC. Profile
of infective endocarditis at a tertiary
care center in Brazil during a seven-year
period: prognostic factors and in-hospital
outcome. Int J Infect Dis 2010; 14(5):
-98.
Garg N, Kandpal B, Garg N, Tewari S,
Kapoor A, Goel P, et al. Characteristics
of infective endocarditis in a developing
country: Clinical profile and outcome
in 192 Indian patients,1992-2001. Int J
Cardiol 2005; 98: 253-60.
Khaled AA, Al-Noami AY, Al-Ansi M, Faiza
AA. Clinical Features and Outcome of
infective endocarditis in Yemeni patients
treated with empirical antibiotic therapy.
Heart Views 2010; 11: 2-9.
Hoen B, Alla F, Selton-Suty C, Béguinot
I, Bouvet A, Briançon S, et al. Changing
profile of infective endocarditis: Results
of a 1-year survey in France. JAMA 2002;
: 75-81.
Khan NU, Farman MT, Sial JA, Achakzai
AS, Saghir T, Ishaq M. Changing trends of
infective endocarditis. J Pak Med Assoc
; 60: 24-27.
Netzer RO, Zollinger E, Seiler C, Cerny
A. Infective endocarditis: clinical spectrum,
presentation and outcome. An analysis
of 212 cases 1980-1995. Heart 2000;
: 25-30.
Moreillon P, Que YA. Infective endocarditis.
Lancet 2004; 363: 139-49.
Castillo JC, Anguita MP, Ramírez A, Siles
JR, Torres F, Mesa D, et al. Long term
outcome of infective endocarditis in
patients who were not drug addicts: A 10
year study. Heart 2000; 83: 525-30.
Tornos P, Iung B, Permanyer-Miralda G,
Baron G, Delahaye F, Gohlke-BärwolfCh,
et al. Infective endocarditis in Europe:
Lessons from the Euro heart survey. Heart
; 91: 571-75.
Ferreiros E, Nacinovich F, Casabé JH,
Modenesi JC, Swieszkowski S, Cortes C,
et al. EIRA-2 Investigators. Epidemiologic,
clinical, and microbiologic profile of
infective endocarditis in Argentina:
A national survey. The Endocarditis
Infecciosa en la República Argentina-2
(EIRA-2) Study. Am Heart J 2006; 151:
-52.
Murdoch DR, Corey GR, Hoen B, Miro
JM, Fowler Jr VG, Bayer As et al: Clinical
presentation, etiology, and outcome
of infective endocarditis in the 21st
century.The international collaboration
on endocarditis-prospective cohort study
Arch Intern Med 2009; 169: 463-73.
Math RS, Sharma G, Kothari SS, Kalaivani
M, Saxena A, Kumar AS, et al. Prospective
study of infective endocarditis from a
developing country. Am Heart J 2011 Oct;
(4): 633-38.
Choudhury R, Grover A, Varma J, Khattri
HN, Anand IS, Bidwai PS, et al. Active
infective endocarditis observed in an
Indian hospital 1981-1991. Am J Cardiol
; 70: 1453-58.
Pazdernik M, Baddour LM, Pelouch
R. Infective endocarditis in the Czech
Republic: eight years of experience at one
of the country’s largest medical centers.
J Heart Valve Dis 2009; 18(4): 395-400.
Durante-Mangoni E, Bradley S, Selton-
Suty C, Tripodi MF, Barsic B, Bouza
E et al. Current features of infective
endocarditis in elderly patients:results
of the International Collaboration on
Endocarditis Prospective Cohort Study.
Arch Intern Med 2008; 168: 2095-103.
Yameogo NV, Kologo KJ, Yameogo AA,
Yonaba C, Millogo GR, Kissou SA et al.
Infective endocarditis in Sub-Saharan
African children, cross-sectional study
about 19 cases in Ouagadougou at Burkina
Faso. Ann Cardiol Angeiol (Paris) 2013; 13.
S0003-3928(13)00020-6. doi: 10.1016/j.
ancard.2013.02.004.
Elbey MA, Akdağ S, Kalkan ME, Kaya
MG, Sayın MR, Karapınar H, et al. A
multicenter study on experience of 13
tertiary hospitals in Turkey in patients with
infective endocarditis. Anadolu Kardiyol
Derg 2013; 13(6): 523-27.
Stockins B, Neira V, Paredes A, Castillo
C, Troncoso A. Profile of patients with
infective endocarditis admitted to a
Chilean regional hospital. Rev Med Chil
; 140(10): 1304-11.
Letaief A, Boughzala E, Kaabia N, Ernez S,
Abid F, Ben Chaabane T. Epidemiology of
infective endocarditis in Tunisia: a 10-year
multicenter retrospective study. Int J Infect
Dis 2007; 11(5): 430-35.
Wilson W, Taubert KA, Gewitz M,
Lockhart, PB, Baddour LM, Levison M et
al: Prevention of infective endocarditis.
Guidelines from the American Heart
Association. Circulation 2007; 116:
-88.