Infective endocarditis

2020 ◽  
pp. 115-128
Keyword(s):  
At Risk ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
High Mortality ◽  
Clinical Management ◽  
Valve Disease ◽  
Educational Issues ◽  
The Uk

Infective endocarditis (IE) is a condition that most commonly occurs in patients with pre-existing valve disease. It affects one in 30 000 people in the UK and is associated with a high mortality rate (15–30% in hospital mortality). Nurses working in the cardiac arena should be aware of those patients who are at risk of developing IE and its clinical management. This chapter covers the aetiology, diagnosis, complications, treatment, nursing considerations, and specific educational issues that are relevant to the overall management and prevention of IE.

Infective endocarditis

2014 ◽  
pp. 97-108
Keyword(s):  
At Risk ◽  
Infective Endocarditis ◽  
Clinical Management ◽  
Valve Disease ◽  
Educational Issues

Infective endocarditis (IE) is a condition that most commonly occurs in patients with pre-existing valve disease. Nurses working in the cardiac arena should be aware of those patients who are at risk of developing IE and its clinical management. The aim of this chapter is to discuss the aetiology, diagnosis, treatment, nursing considerations, and specific educational issues that are relevant to the overall management and prevention of IE.

Conclusion and future directions

ESC CardioMed ◽  
2018 ◽  
pp. 1738-1740
Author(s):  
Gilbert Habib
Keyword(s):  
Infective Endocarditis ◽  
Hospital Mortality ◽  
High Mortality ◽  
Severe Form ◽  
Valve Disease ◽  
Future Directions

Infective endocarditis is a severe form of valve disease still associated with an unacceptably high mortality (10–30% in-hospital mortality). How can you improve the prognosis of infective endocarditis? This chapter summarizes the main achievements and future directions in prevention, diagnosis, management, and therapy of patients with infective endocarditis.

scholarly journals Infective endocarditis at a tertiary care hospital in South Korea

Heart ◽  
2020 ◽  
Vol 107 (2) ◽  
pp. 135-141 ◽  
Author(s):  
Jung Ho Kim ◽  
Hi Jae Lee ◽  
Nam Su Ku ◽  
Seung Hyun Lee ◽  
Sak Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
South Korea ◽  
Hospital Mortality ◽  
Care Hospital ◽  
Multivariable Logistic Regression ◽  
Long Term Prognosis

ObjectiveThe treatment of infective endocarditis (IE) has become more complex with the current myriad healthcare-associated factors and the regional differences in causative organisms. We aimed to investigate the overall trends, microbiological features, and outcomes of IE in South Korea.MethodsA 12-year retrospective cohort study was performed. Poisson regression was used to estimate the time trends of IE incidence and mortality rate. Risk factors for in-hospital mortality were identified with multivariable logistic regression, and model comparison was performed to evaluate the predictive performance of notable risk factors. Kaplan-Meier survival analysis and Cox regression were performed to assess long-term prognosis.ResultsWe included 419 patients with IE, the incidence of which showed an increasing trend (relative risk 1.06, p=0.005), whereas mortality demonstrated a decreasing trend (incidence rate ratio 0.93, p=0.020). The in-hospital mortality rate was 14.6%. On multivariable logistic regression analysis, aortic valve endocarditis (OR 3.18, p=0.001), IE caused by Staphylococcus aureus (OR 2.32, p=0.026), neurological complications (OR 1.98, p=0.031), high Sequential Organ Failure Assessment score (OR 1.22, p=0.023) and high Charlson Comorbidity Index (OR 1.11, p=0.019) were predictors of in-hospital mortality. Surgical intervention for IE was a protective factor against in-hospital mortality (OR 0.25, p<0.001) and was associated with improved long-term prognosis compared with medical treatment only (p<0.001).ConclusionsThe incidence of IE is increasing in South Korea. Although the mortality rate has slightly decreased, it remains high. Surgery has a protective effect with respect to both in-hospital mortality and long-term prognosis in patients with IE.

scholarly journals 146. Infective Endocarditis in South Korea: a 12-year Single-Center Experience of 419 Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S100-S101
Author(s):  
Jung Ho Kim ◽  
Hi Jae Lee ◽  
Woon Ji Lee ◽  
Hye Seong ◽  
Jin young Ahn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
South Korea ◽  
Hospital Mortality ◽  
Incidence Rate ◽  
Logistic Regression Analysis

Abstract Background Infective endocarditis (IE) is a potentially lethal disease that has undergone constant changes in epidemiology and pathogen. Treatment of IE has become more complex with today’s myriad healthcare-associated factors as well as regional differences in causative organisms. Therefore, it is necessary to investigate the overall trends, microbiological features, clinical characteristics and outcomes of IE in South Korea. Methods We performed a retrospective cohort study of patients with the diagnosis of probable or definite IE according to the modified Duke Criteria admitted to a tertiary care center in South Korea between November 2005 and August 2017. Poisson log-linear regression was used to estimate time trends of IE incidence rate and mortality rate. Risk factors for in-hospital mortality were evaluated by multivariate logistic regression analysis including an interaction term. Results There were 419 IE patients (275 male vs. 144 female) during the study period. The median age of the patients was 56 years. The annual incidence rate of IE of our institution was significantly increased. (RR 1.05; 95% CI, 1.02–1.08; P = 0.006) The mortality rate showed trends toward down, but not statistically significant (P = 0.875). IE was related to a prosthetic valve in 15.0% and 21.7% patients developed IE during hospitalization. The mitral valve was the most commonly affected valve (61.3%). Causative microorganisms were identified in 309 patients (73.7%) and included streptococci (34.6%), followed by Staphylococcus aureus (15.8%) and enterococci (7.9%). The in-hospital mortality rate was 14.6%. Logistic regression analysis found aortic valve endocarditis (OR 3.18; P = 0.001), IE caused by staphylococcus aureus (OR 2.32; P = 0.026), a presence of central nervous system embolic complication (OR 1.98; P = 0.031), a high SOFA score (OR 1.22; P = 0.023) and a high Charlson’s comorbidity index (OR 1.11; P = 0.019) as predictors of in-hospital mortality. On the other hand, surgical intervention for IE was found to be a protective factor against mortality. (OR 0.25, P < 0.001) Conclusion Although IE has been increasing, the mortality rate has not yet reduced significantly. Studies on causative organisms of IE and risk factors for mortality are warranted in improving prognosis. Disclosures All authors: No reported disclosures.

scholarly journals Epidemiology and risk factors of infective endocarditis in a tertiary hospital in China from 2007 to 2016

2019 ◽  
Author(s):  
Zhenzhu Wu ◽  
Yi Chen ◽  
Tingting Xiao ◽  
Tianshui Niu ◽  
Qingyis Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Tertiary Hospital ◽  
The Past ◽  
Increasing Trend ◽  
One Year

Abstract Background: To explore the trends in epidemiology and risk factors related to the prognosis of infective endocarditis in a teaching hospital over the past ten years. Methods: A retrospective cohort study was performed. A total of 407 consecutive patients were included. The clinical characteristics and risk factors related to the prognosis of infective endocarditis during this period were analyzed. Results: A total of 407 patients with infective endocarditis were included, the average age was 48 ±16 years old with an increasing trend and in-hospital mortality rate was 10.6% and one-year mortality rate was 12.2%. Among patients with underlying heart disease, congenital heart disease was the most common(25.8%), followed by rheumatic heart disease which showed a decreased trend during this period (P<0.001). There were 222(54.5%) positive blood cultures and streptococci (44.1%) was the main pathogens with an increasing trend. There were 403 patients (99%) with surgical indications, but only 234 patients (57.5%) received surgical treatment. Hemodialysis (P = 0.041, OR = 4.697, 95% CI 1.068-20.665), pulmonary hypertension (P = 0.001, OR = 5.308, 95% CI 2.034-13.852), Pitt score ≥ 4 (P <0.001, OR = 28.5, 95% CI 5.5-148.1) and vegetation length＞30mm (P = 0.011, OR = 13.754, 95% CI 1.832-103.250) were independent risk factors for in-hospital mortality. Conclusions: There was no significant change in the overall incidence of IE, the clinical features of IE have changed slightly during the past ten years. Streptococci IE was still the predominant. IE patients with hemodialysis, pulmonary hypertension, Pitt score ≥ 4 and vegetation length＞30mm had an worse in-hospital outcome.

scholarly journals Predictors of In-Hospital Mortality for Road Traffic Accident-Related Severe Traumatic Brain Injury

2021 ◽  
Vol 11 (12) ◽  
pp. 1339
Author(s):  
Chien-Hung Chen ◽  
Yu-Wei Hsieh ◽  
Jen-Fu Huang ◽  
Chih-Po Hsu ◽  
Chia-Ying Chung ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Prothrombin Time ◽  
High Mortality ◽  
Clinical Characteristics ◽  
Road Traffic ◽  
Road User ◽  
Severe Tbi

(1) Background: Road traffic accidents (RTAs) are the leading cause of pediatric traumatic brain injury (TBI) and are associated with high mortality. Few studies have focused on RTA-related pediatric TBI. We conducted this study to analyze the clinical characteristics of RTA-related TBI in children and to identify early predictors of in-hospital mortality in children with severe TBI. (2) Methods: In this 15-year observational cohort study, a total of 618 children with RTA-related TBI were enrolled. We collected the patients’ clinical characteristics at the initial presentations in the emergency department (ED), including gender, age, types of road user, the motor components of the Glasgow Coma Scale (mGCS) score, body temperature, blood pressure, blood glucose level, initial prothrombin time, and the intracranial computed tomography (CT) Rotterdam score, as potential mortality predictors. (3) Results: Compared with children exhibiting mild/moderate RTA-related TBI, those with severe RTA-related TBI were older and had a higher mortality rate (p < 0.001). The in-hospital mortality rate for severe RTA-related TBI children was 15.6%. Compared to children who survived, those who died in hospital had a higher incidence of presenting with hypothermia (p = 0.011), a lower mGCS score (p < 0.001), a longer initial prothrombin time (p < 0.013), hyperglycemia (p = 0.017), and a higher Rotterdam CT score (p < 0.001). Multivariate analyses showed that the mGCS score (adjusted odds ratio (OR): 2.00, 95% CI: 1.28–3.14, p = 0.002) and the Rotterdam CT score (adjusted OR: 2.58, 95% CI: 1.31–5.06, p = 0.006) were independent predictors of in-hospital mortality. (4) Conclusions: Children with RTA-related severe TBI had a high mortality rate. Patients who initially presented with hypothermia, a lower mGCS score, a prolonged prothrombin time, hyperglycemia, and a higher Rotterdam CT score in brain CT analyses were associated with in-hospital mortality. The mGCS and the Rotterdam CT scores were predictive of in-hospital mortality independently.

scholarly journals Epidemiology and risk factors of infective endocarditis in a tertiary hospital in China from 2007 to 2016

2020 ◽  
Author(s):  
Zhenzhu Wu ◽  
Yi Chen ◽  
Tingting Xiao ◽  
Tianshui Niu ◽  
Qingyi Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Tertiary Hospital ◽  
The Past ◽  
Increasing Trend ◽  
One Year

Abstract Background: To explore the trends in epidemiology and the risk factors related to the prognosis of infective endocarditis in a tertiary hospital over the past ten years. Methods: A retrospective cohort study was performed. A total of 407 consecutive patients who were admitted with infective endocarditis were included. The clinical characteristics and the risk factors related to the prognosis of infective endocarditis during this period were analyzed. Results: A total of 407 patients with infective endocarditis were included, the average age was 48 ±16 years old with an increasing trend and in-hospital mortality rate was 10.6% and one-year mortality rate was 11.3%. Among patients with underlying heart disease, congenital heart disease was the most common(25.8%), followed by rheumatic heart disease(17.0%) which showed a decreased trend during this period (P<0.001). There were 222(54.5%) patients with positive blood cultures results and Streptococci (24.6%) was the main pathogens with an increasing trend. There were 403 patients (99%) with surgical indications, but only 235 patients (57.7%) received surgical treatment. Hemodialysis (P = 0.041, OR = 4.697, 95% CI 1.068-20.665), pulmonary hypertension (P = 0.001, OR = 5.308, 95% CI 2.034-13.852), Pitt score ≥ 4 (P <0.001, OR = 28.594, 95% CI 5.561-148.173) and vegetation length＞30mm (P = 0.011, OR = 13.754, 95% CI 1.832-103.250) were independent risk factors for in-hospital mortality. Conclusions: There were no significant change in the overall incidence of infective endocarditis, but the clinical features of infective endocarditis had slightly changed during the past ten years. Streptococci infective endocarditis was still the predominant. Patients with hemodialysis, pulmonary hypertension, Pitt score ≥ 4 and vegetation length＞30mm had an worse in-hospital outcome. Keywords: Infective endocarditis, epidemiology, risk factors, mortality.

scholarly journals Does Risk Calculator by Nationwide Survey Match The Postoperative Outcome in Patients Who Underwent Major Hepatectomy?

2020 ◽  
Author(s):  
Atsushi Nanashima ◽  
Naoya Imamura ◽  
Masahide Hiyoshi ◽  
Koichi Yano ◽  
Takeomi Hamada ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hospital Mortality ◽  
High Mortality ◽  
Major Hepatectomy ◽  
Nationwide Survey ◽  
Hospital Death ◽  
Risk Calculator ◽  
Biliary Malignancy ◽  
Co Morbidity ◽  
Hepatobiliary Diseases

Abstract Background: To clarify significance of the present National Clinical Database risk calculator (NCD-RC) for hepatectomy in Japan, relationship between perioperative parameters or outcomes in major hepatectomy and the mortality rate by NCD-RC was examined. Methods: Patient demographics, co-morbidity, surgical records, postoperative morbidity or mortality were examined and compared to the 30 days- or in-hospital-mortality rate among 55 patients with hepatobiliary diseases who underwent hemi- or more-extended hepatectomy and central (segment 458) hepatectomy. The cut-off percent for high risk mortality before hepatectomy was set at 5% in this period. Results: In-hospital morbidity over CD III was 17 (28%), The 30-day mortality and in-hospital mortality was nil and two (3%), respectively. Male patient showed significantly higher in-hospital mortality rate (p<0.01). In the 37 patients (group woML), mean age was 67.8±8.7 years old ranging 45 and 84. Others included A) with severe complications or mortality in whom low mortality rate (group wML, n=13), B) without severe complications neither mortality in whom high mortality rate (group woMH, n=7), and C) with severe complications or mortality in whom high mortality rate (group wMH, n=4 (6.5%)). Age, distribution of elderly patients, gender, the hepatobiliary diseases and the prevalence of preoperative co-morbidity were not significantly different between groups. In the group wML, the bile leakage was dominant and, however, the in-hospital death was not observed. In the group wMH, all operations were right hepatectomy with bile duct resection (RH-BDR) for biliary malignancy and two died of hepatic failure and, however, the prevalence of RH-BDR was not significantly higher in comparison with other groups. Conclusions: Predictive mortality rate by risk calculator under nationwide survey did not always match with patient outcomes in the actual clinical setting and further improvement will be required. In case of RH-BDR for biliary malignancy with high predictive rate, the careful perioperative managements is important under the present nationwide database.

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