IN-HOSPITAL OUTCOME OF PATIENTS WITH INFECTIVE ENDOCARDITIS: A RETROSPECTIVE ANALYSIS
PDF

How to Cite

Iqbal, A., Fahim, M., Ikramullah, ., Khan, N., & Hafizullah, M. (2015). IN-HOSPITAL OUTCOME OF PATIENTS WITH INFECTIVE ENDOCARDITIS: A RETROSPECTIVE ANALYSIS. KHYBER MEDICAL UNIVERSITY JOURNAL, 7(3). Retrieved from https://www.kmuj.kmu.edu.pk/article/view/13114

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).

PDF

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.

Work published in KMUJ is licensed under a

 Creative Commons Attribution-NonCommercial 2.0 Generic License.

Creative Commons License

Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.