Risk Factors for In-Hospital Mortality During Infective Endocarditis in Patients With Congenital Heart Disease

2008 ◽  
Vol 101 (1) ◽  
pp. 114-118 ◽  
Author(s):  
Masao Yoshinaga ◽  
Koichiro Niwa ◽  
Atsuko Niwa ◽  
Naruhiko Ishiwada ◽  
Hideto Takahashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Hospital Mortality ◽  
Congenital Heart

Predictive factors of death associated with infective endocarditis in adult patients with congenital heart disease

2020 ◽  
pp. 204887262090139
Author(s):  
Reaksmei Ly ◽  
Fabrice Compain ◽  
Bamba Gaye ◽  
Florence Pontnau ◽  
Melissa Bouchard ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Hospital Mortality ◽  
Predictive Factors ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Adult Patients ◽  
Hospital Death ◽  
Adult Congenital

Aims: Infective endocarditis is a severe infection which can occur in adult patients with congenital heart disease. We aimed to determine outcomes and risk factors of death in adult congenital heart disease and to investigate differences with infective endocarditis in non-congenital heart disease. Methods and results: Between March 2000 and June 2018, 671 consecutive episodes of infective endocarditis in adult patients were retrospectively recorded. Cases were classified according to the modified Duke classification. All adult congenital heart disease cases were managed by infectious disease specialists and adult congenital heart disease cardiologists. During this period, 142 infective endocarditis episodes (21%) occurred in adult congenital heart disease patients with simple (46.5%), moderate (21.1%), or complex (32.4%) congenital heart disease. In-hospital mortality was 12.7%. The strongest predictive factors of in-hospital death in multivariate analysis were complexity of congenital heart disease (odds ratio (OR) 8.02, 95% confidence interval (CI) 1.53–42.07), age (OR 1.05, 95% CI 1.00–1.19) and white blood cell count 12 g/L or greater (OR 8.72, 95% CI 2.42–31.43). Patients with congenital heart disease were significantly younger (median age 36 vs. 67 years, P<0.001), had undergone more redo cardiac surgeries (35.7% vs. 11.3%, P<0.01) and presented with more right-sided infective endocarditis (39.4% vs. 7.9%, P<0.01) than patients without congenital heart disease. Congenital heart disease was associated with two-fold lower in-hospital mortality rates (OR 0.37, 95% CI 0.19–0.74), independently of age, gender, obesity, renal function and side of infective endocarditis. Conclusion: Although mortality associated with infective endocarditis is lower in adult patients with congenital heart disease than patients without congenital heart disease, infective endocarditis mortality is particularly high in patients with complex congenital heart disease. Education and prevention about the risk of infective endocarditis is essential, especially in this group.

scholarly journals Severe postoperative hyperbilirubinemia in congenital heart disease

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 1276-1285
Author(s):  
Xiaolan Chen ◽  
Ming Bai ◽  
Shiren Sun ◽  
Xiangmei Chen
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Hospital Mortality ◽  
Congenital Heart ◽  
Kidney Injury ◽  
Term Survival ◽  
Risk Of Mortality ◽  
Long Term Mortality

Abstract Purpose The purpose of our present study was to explore the characteristics and outcomes of congenital heart disease (CHD) patients with severe postoperative hyperbilirubinemia. Methods All patients who underwent cardiopulmonary bypass surgical treatment for CHD and had severe postoperative hyperbilirubinemia (total bilirubin [TB] ≥85.5 μmol/L) in our center between January 2015 and December 2018 were retrospectively screened. Univariate and multivariate analyses were employed to identify risk factors for the study endpoints, including postoperative acute kidney injury (AKI), in-hospital mortality, and long-term mortality. Results After screening, 86 patients were included in our present study. In-hospital mortality was 10.9%. Fifty-one (59.3%) patients experienced AKI, and four (4.7%) patients received continuous renal replacement therapy. Multivariate analysis identified that the peak TB concentration (P = 0.002) and duration of mechanical ventilation (P = 0.008) were independent risk factors for in-hospital mortality, and stage 3 AKI was an independent risk factor for long-term mortality. The optimal cutoff value for peak TB concentration was 125.9 μmol/L. Patients with a postoperative TB level ≥125.9 μmol/L had worse long-term survival. Conclusion Hyperbilirubinemia was a common complication after CHD surgery. CHD patients with severe postoperative hyperbilirubinemia ≥125.9 μmol/L and AKI had a higher risk of mortality.

scholarly journals Characteristics of Children Hospitalized with Infective Endocarditis at Dhaka Shishu Hospital

2019 ◽  
Vol 12 (1) ◽  
pp. 33-39
Author(s):  
Rezoana Rima ◽  
Mohammad Abdullah Al Mamun
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Congenital Heart ◽  
Cardiac Involvement ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Pediatric Age Group ◽  
High Index Of Suspicion

Background: The characteristics of infective endocarditis (IE) have significantly changed in pediatric age group during last few decades. The present study was conducted to study the clinical & lab profile, risk factors, site of cardiac involvement and outcome of infective endocarditis in the largest children hospital of Bangladesh. Methods: This prospective cross-sectional study was conducted in cardiology department with a diagnosis of IE from February 2014 to August 2016. Twenty- four children fulfilled the modified Duke diagnostic criteria. Results: Definite IE was found in 58% (14/24) patients, while the rest had possible IE. The most common presenting symptom was prolonged fever (> 2 weeks) & heart murmur. Most commonly encountered risk factors included congenital heart disease (54%), most commonly ventricular septal defect (21%). Two patients (8.3%) had history of rheumatic heart disease. Other important risk factors include post cardiac surgery (16.7%), prolonged ICU stay of neonates (20.8%). Nineteen patients (79%) were classified as having culture-negative endocarditis and five (21%) as culture positive. The most frequently isolated organisms were streptococci and followed by staphylococci and candida. Fifteen (62.5%) patients had right-sided cardiac involvement. Seven (29%) patients died of endocarditis or its complications. Conclusion: Clinicians should have a high index of suspicion of endocarditis in persistently febrile patients with congenital heart disease and send blood cultures or refer appropriately before prescribing antibiotics. Cardiovasc. j. 2019; 12(1): 33-39

P1798Assessing attitudes and knowledge of infective endocarditis in adult survivors of congenital heart disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Krishanthasan ◽  
S Haider ◽  
A Khokhar ◽  
K Dimopoulos ◽  
I Rafiq
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Antibiotic Treatment ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Significant Morbidity

Abstract Background Adults with congenital heart disease (ACHD) have an increased risk of infective endocarditis (IE), which is associated with significant morbidity and mortality. This risk is further compounded by patient-related factors such as education and awareness of IE. The onus of patient education falls on both patient and physician, and is paramount to successful outcomes. Our study sought to evaluate patients' understanding of the risks, preventative measures and symptoms of IE, and to identify high-risk ACHD patients who would benefit from targeted education. Methods A cross-sectional study was conducted using a pre-tested questionnaire to assess knowledge of and attitudes towards IE. Patients attending the outpatient department of a tertiary referral centre completed the questionnaires independently. Baseline demographics and clinical data were collected from electronic patient records. Results 132 questionnaires were completed (median age 38 years, 50% male). 106 patients (80%) had previous surgical or percutaneous interventions and 7 patients (5%) had suffered with infective endocarditis in the past. 37% were able to accurately define IE. Out of a range of symptoms, most patients chose temperature (47%) and tiredness (39%) as classical symptoms of IE, however none correctly identified all listed symptoms as potential signs of IE. The majority of patients knew tooth abscess (58%) and body piercings (50%) were risk factors for IE. A fifth of patients (20%) were failing to have annual dental check-ups. 22% thought that IE would only require a few days stay as an inpatient and only 20% of patients were aware of the requirement for prolonged antibiotic treatment and the majority (63%) were unaware of the potential need for open heart surgery. 1 in 4 patients could recall having received information regarding IE. A third of patients reported that they would have made lifestyle changes had they known that IE required prolonged intravenous antibiotic treatment and could result in open heart surgery and death. Discussion Our study highlights key issues in the management of ACHD. Moving forward with the continuously growing population of patients we need to focus on the multi-disciplinary approach including specialist clinical nurses and increasing awareness online and through meetings and patient days as well as the importance of transition services as paediatric patients move across to adult specialists. General physcians will also encounter ACHD, therefore it is important to ensure awareness is widespread in the form online platforms and leaflets. We must also acknowledge the impact of guidelines and ensure there is still a significant focus on IE within them. To conclude, despite the significant morbidity and mortality associated with IE in ACHD, patient awareness of symptoms, risk factors and consequences is limited. Promotion of IE awareness is a cost-effective intervention, which can reduce the incidence and complications of IE.

Risk Factors for Gross Motor Dysfunction in Infants With Congenital Heart Disease

2011 ◽  
Vol 24 (3) ◽  
pp. 246-258 ◽  
Author(s):  
Suzanne H. Long ◽  
Bev J. Eldridge ◽  
Mary P. Galea ◽  
Susan R. Harris
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Motor Dysfunction ◽  
Gross Motor
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