Aetiology, clinical characteristics, and risk factors influencing mortality in patients with infective endocarditis: a retrospective study.

Abstract

Introduction: Infective endocarditis is defined as an infection of the endothelial surfaces in the heart (valves and endocardium), prosthetic heart valves, and intracardiac devices (such as pacemaker leads and ventricular assist devices). Due to diagnostic challenges, determining the true incidence of infective endocarditis is difficult. Despite advancements in diagnosis and treatment, incidence and mortality rates have not decreased. In this study, we evaluated the clinical and laboratory parameters of patients with infective endocarditis followed in our hospital between 2005 and 2018 and assessed their relationship with in-hospital and one-year mortality.

Methods: This study retrospectively analysed 145 patients aged ≥18 years who were diagnosed with infective endocarditis and followed in our hospital between 2005 and 2018. Data were analysed using IBM SPSS V23. Statistical analyses included the Shapiro-Wilk test, T-test, Mann-Whitney U test, and Chi-square test.

Results: The average age of the patients was 53 (18-86), and 52.4% (n = 76) were male. In 34% (n = 37) of our patients, the predisposing factor for infective endocarditis was rheumatic valve disease. In-hospital mortality was 31.7%, and one-year mortality was 40.6%. A statistically significant difference in in-hospital mortality was found between combination therapy (23%) and medical therapy (40.8%). Mitral valve involvement was the most common, occurring in 48.3% of patients. Staphylococci were the most frequently isolated microorganisms in blood cultures (41.4%). Heart failure was the most common complication and was associated with the highest mortality rate (23.4%). NYHA was an independent predictor of in-hospital mortality.

Conclusion: In our study, surgical intervention, i.e. combination therapy, applied after two weeks of antibiotic treatment, was found to be more effective. Early combination therapy may be life-saving.