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 changes 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.

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 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 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 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 (24.1%) 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 = 28.594, 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 was no significant change in the overall incidence of infective endocarditis, the clinical features of infective endocarditis have changed slightly during the past ten years. Streptococci infective endocarditis was still the predominant. Infective endocarditis patients with hemodialysis, pulmonary hypertension, Pitt score ≥ 4 and vegetation length＞30mm had an worse in-hospital outcome.

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 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.

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

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 The clinical features and prognosis of infective endocarditis in the elderly from 2007-2016 in a tertiary hospital in China

2019 ◽  
Author(s):  
Zhenzhu Wu ◽  
Yi Chen ◽  
Tingting Xiao ◽  
Tianshui Niu ◽  
Qingyi Shi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Renal Insufficiency ◽  
Hospital Mortality ◽  
Older Patients ◽  
The Elderly ◽  
Tertiary Hospital ◽  
Old Patients ◽  
Younger Patients ◽  
One Year

Abstract Background Infective endocarditis (IE) is a serious disease, with a worse prognosis in the elderly. Aims To explore the clinical features and prognosis of old patients with IE in a tertiary hospital. Methods A retrospective cohort study was conducted. A total of 407 patients diagnosed as IE were divided into two groups: 348 patients under 65 years old and 59 patients over 65 years old. Results For older patients, clinical symptoms such as fever, anemia, and heart murmur were as common as in younger patients. Comorbidities like hypertension (P＜0.001) and diabetes (P=0.023) were more common in older patients. Complications like renal insufficiency (P=0.027) and arrhythmia (P＜0.001) were also more common in older patients. The old patients had a lower operation rate (40.7% vs 60.6%, P=0.004) and higher in-hospital mortality (20.3% vs 8.9%, P=0.008) compared with the younger patients. Pitt score ≥4 (P=0.043, OR=28.0, 95% CI 1.1-700.4) and renal insufficiency (P=0.011, OR=34.2, 95% CI 2.2-521.2) were independent risk factors of in-hospital mortality for older patients. Surgical treatment was a significant predictor of one-year mortality even after adjusting for the confounders (HR = 1.722, 95% CI 0.563-5.365, P = 0.005).The one-year survival rate was higher for older patients with surgical intervention than those without (95.8% vs 68.6%, P=0.007). Conclusions IE in older patients present with more comorbidities and complications as well as a higher mortality than younger patients. Surgery were underused in old patients and old patients with surgical treatment had better long-term prognosis.

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.

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