Features of infective endocarditis in a contemporary cohort of persons who inject drugs: a matched comparison analysis of long-term prognostic factors

Ramadan, Mohammad Said; Bertolino, Lorenzo; Boccia, Filomena; Hamieh, Mahmoud; Peluso, Anna Maria; Gallo, Raffaella; Patauner, Fabian; De Santo, Luca Salvatore; Carozza, Antonio; Zampino, Rosa; Durante-Mangoni, Emanuele; ,

doi:10.1007/s11739-023-03502-6

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2024

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Cited by 2 publications

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Embolic complications in a large contemporary cohort of infective endocarditis: do we need score model?

Bertolino,

Unar,

Patauner

et al. 2024

Infection

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Embolic complications in a large contemporary cohort of infective endocarditis: do we need score model?

Bertolino,

Unar,

Patauner

et al. 2024

Infection

View full text Add to dashboard Cite

Correlates of embolic complications in a contemporary cohort of infective endocarditis: performance of a diagnostic score model

Bertolino,

Unar,

Patauner

et al. 2024

Preprint

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Purpose Infective endocarditis (IE) is a heterogeneous disease undergoing epidemiological changes. Whether those changes have an impact on the correlates of embolic events (EE) remains unclear. We analyzed the correlates of EE and the performance of a diagnostic score model in a large contemporary cohort. Methods This is a retrospective observational study including patients with definite valve IE admitted between 2000 and 2023. EE were defined as acute complications causing overt clinical manifestations. The study primary aim was to identify independent correlates of EE. Results 715 valve-IE cases were included. EE occurred in 41.4% (n=296) of patients. S. aureus etiology (OR 2.708[1.268–5.786];p=0.010), C-reactive protein>6.7 mg/dL (OR 2.415[1.371–4.252];p=0.002), and splenomegaly (OR 2.858[1.620–5.403];p<0.001) were independently associated with EE. VS≥14 mm (OR 1.575[0.925–2.682];p=0.061) and D-dimers >747 ng/mL (OR 1.677[0.976–2.881];p=0.061) showed a trend for independent association. These variables were included in a diagnostic score model. A stepwise increase of EE occurrence was found stratifying patients into 3 categories (score 0-2–22%; score 3-5–53%; score 6-8–78%;p<0.001). A cut-off of 2 showed a sensitivity of 83% and a specificity of 50% (AUROC 0.732; p<0.001). Conclusion EE were independently associated to S. aureus, C-reactive protein and splenomegaly and less strongly linked to vegetation size in our cohort. These results may be explained by a change in embolic complications correlates linked to the epidemiological shift. The discriminative ability of our score was only fair. At present, clinicians should rely upon clinical and imaging data to diagnose EE.

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Features of infective endocarditis in a contemporary cohort of persons who inject drugs: a matched comparison analysis of long-term prognostic factors

Cited by 2 publications

References 36 publications

Embolic complications in a large contemporary cohort of infective endocarditis: do we need score model?

Embolic complications in a large contemporary cohort of infective endocarditis: do we need score model?

Correlates of embolic complications in a contemporary cohort of infective endocarditis: performance of a diagnostic score model

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