Clinical Characteristics and Outcome of Infective Endocarditis in Individuals of the General Population Managed at a Teaching Hospital Without Cardiac Surgery Facilities. Study of 120 Cases

López‐Dupla, Miguel; Hernández, Sebastián; Olona, Montserrat; Mercé, Jordi; Lorenzo, Alfons; Tapiol, J.; Gómez, Frederic; Santamaria, Joseph; García, Rosa; Auguet, Teresa; Richart, C; Castells, E; Bardajı́, Alfredo; Vidal, Francesc

doi:10.1016/s1885-5857(07)60062-0

Cited by 10 publications

(13 citation statements)

References 30 publications

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“…[21], the benefits of a comprehensive approach to this difficult disease are worthy of note. Similarly, one study conducted at a teaching hospital without a cardiac surgery department showed that the introduction of a multidisciplinary IE team, which included a consultant cardiac surgeon, was associated with a significant increase in referrals for surgery (from 14.5% to 34.5%) and a decrease in in‐hospital mortality (20.9–13.8%, p not significant) [2].…”

Section: Discussionmentioning

confidence: 99%

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Prognosis of left‐sided infective endocarditis in patients transferred to a tertiary‐care hospital—prospective analysis of referral bias and influence of inadequate antimicrobial treatment

Fernández-Hidalgo

Almirante

Tornos³

et al. 2011

Clinical Microbiology and Infection

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The aims of this study were to compare the characteristics of adult patients with left-sided infective endocarditis (LSIE) diagnosed and treated in a tertiary-care hospital with those of patients referred from a second-level community hospital, and to establish the accuracy of diagnosis and adequacy of treatment in referred patients and the influence of this factor on outcome. A prospective observational cohort study was conducted at Hospital Universitari Vall d'Hebron, a 1000-bed teaching hospital in Barcelona (Spain) and a referral centre for cardiac surgery. One hundred and fourteen of 337 (34%) episodes of LSIE treated in our hospital occurred in transferred patients. As compared with patients diagnosed in our hospital, transferred patients acquired LSIE within the healthcare system less often (16.7% vs. 38.1%, p <0.001), were in better health (Charlson index 3 (interquartile range (IQR)) 1-4) vs. 4 (IQR 2-6), p <0.001), had more complications (94.7% vs. 78.9%, p <0.001), underwent more operations (69.3% vs. 22.1%, p <0.001), and experienced similar mortality (22.8% vs. 31.4%, p 0.100). Only 52 of 114 (45.6%) referred patients received an antimicrobial regimen included in the American, European or Spanish guidelines at the hospital of origin. After adjustment for congestive heart failure and staphylococcal infection in multivariate logistic regression, inadequate or no antimicrobial treatment at origin was a risk factor for in-hospital mortality (OR 3.3, 95% CI 1.1-10.0, p 0.030). Errors in the initial antimicrobial treatment prescribed for LSIE are associated with greater mortality.

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Section: Discussionmentioning

confidence: 99%

“…To date, few studies have focused on the selection bias in IE patients transferred to hospitals with cardiac surgery departments [12], or the reasons for the transfer [2]. In addition, there is only one published study evaluating the quality of IE management, although it did not analyse the influence of this factor on outcome [13].…”

Section: Introductionmentioning

confidence: 99%

Prognosis of left‐sided infective endocarditis in patients transferred to a tertiary‐care hospital—prospective analysis of referral bias and influence of inadequate antimicrobial treatment

Fernández-Hidalgo

Almirante

Tornos³

et al. 2011

Clinical Microbiology and Infection

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“…According to the literature, musculoskeletal manifestations in patients with IE are part of the complex symptomatology, their presence worsening the clinical course of the disease and increasing the duration of hospitalization. In some instances, these symptoms may arise at onset of the disease in the absence of specific IE clinical signs, causing difficulties in diagnosis establishment and consequently, appropriate treatment initiation [9][10] . However, musculoskeletal changes occur more frequently during the course of the disease and represent manifestations of its complications, more frequently neurological and embolic ones.…”

Section: Resultsmentioning

confidence: 99%

The Musculoskeletal System Involvement in Patients With Infective Endocarditis

Grejdieru¹,

Samohvalov²,

Mazur-Nicorici³

et al. 2018

Arch Balk Med Union

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Affectation du système musculosquelettique chez les patients atteints d'endocardite infectieuse Introduction. L'endocardite infectieuse (EI) est un trouble cardiovasculaire grave portant sur les valves natives, l'endocarde ventriculaire ou auriculaire, des corps étrangers intracardiaques (valves prothétiques, pacemaker ou défibrillateur intracardiaque) et extracardiaques (système musculosquelettique, neurologique, néphrologique etc.) des complications avec une mortalité élevée et à mauvais pronostic. Les objectifs étaient d'évaluer les caractéristiques cliniques et de laboratoire de l'endocardite infectieuse associée aux manifestations musculosquelettiques. Méthodes. L'étude a été menée sur un échantillon de 235 patients, 185 étant hospitalisés dans les sections de cardiologie des départements spécialisés, y compris quatre centres médicaux, entre novembre 2014 et mars 2016. Tous les patients inclus à l'étude remplissant les critères diagnostiques de l'endocardite infectieuse développés selon Duke Endocarditis Service (Durham, Caroline du Nord), révisés en 1994 et 2007. Résultats. Selon la présence ou l'absence de manifestations musculosquelettiques (MMS), les patients ont été divisés en 2 groupes: 1er groupe-90 avec EI et MMS (38%) et 2ème groupe-145 patients recevant une avec EI sans MMS (72%). De cette façon, nous

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“…2,12 Infective endocarditis can occur in children without previously cardiac defects in 20% cases. 13,14 Rightsided IE rarely occurs with 5-10% incidence from all cases, especially in HIV or immunosuppresed patients. Infections related with low sterility of intravenous (IV) injection, contaminated IV drugs, and immunity abnormalities.…”

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confidence: 99%

“…5 Negative blood culture can be found in 4%-31% from all IE patients. 14,22,23 There are three categories of diagnostic possibilites using the modified Duke criteria: definite, possible, and rejected. A diagnosis of definite IE is made by pathologic evidence and fulfillment of pathologic evidence of IE (microorganism demonstrated by culture and histologic examination) and clinical criteria is met by the presence of two major criteria, one major and three minor criteria, or five minor criteria.…”

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confidence: 99%

Infective Endocarditis in a ?-thalassemia Major Child

et al. 2015

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Almost all patients who develop infective endocarditis (IE) had history of congenital or acquired heart disease.We report a 9 years old boy who was diagnosed as ?-thalassemia major since age 1.5 years, admitted to hospital with chief complaint of difficulty of breathing for 1 week before admission, accompanied by fever. Holosystolic murmur of grade 3/6 was found in the lower left sternal border along with hepatosplenomegaly. Chest x-ray depicted right ventricle enlargement and opaque densities in the middle field of left lung. Blood culture showed growth of Staphylococcus aureus. Echocardiography detected thickening tricuspid valve with oscillating mass in the tricuspid valve, severe pulmonary hypertension, and minimal pericardial effusion. Diagnosis of IE was made. After clinical improvement he was discharged with good condition. The diagnosis of IE in children without heart defects is difficult to establish and right-sided IE is rare in children that a high suspicion index should be considered. DOI: http://dx.doi.org/10.3329/cardio.v7i2.22263 Cardiovasc. j. 2015; 7(2): 145-149

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Clinical Characteristics and Outcome of Infective Endocarditis in Individuals of the General Population Managed at a Teaching Hospital Without Cardiac Surgery Facilities. Study of 120 Cases

Cited by 10 publications

References 30 publications

Prognosis of left‐sided infective endocarditis in patients transferred to a tertiary‐care hospital—prospective analysis of referral bias and influence of inadequate antimicrobial treatment

Prognosis of left‐sided infective endocarditis in patients transferred to a tertiary‐care hospital—prospective analysis of referral bias and influence of inadequate antimicrobial treatment

The Musculoskeletal System Involvement in Patients With Infective Endocarditis

Infective Endocarditis in a ?-thalassemia Major Child

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