Characterization, epidemiological profile and risk factors for clinical outcome of infective endocarditis from a tertiary care centre in Turkey

Infect Dis (Lond). 2019 Oct;51(10):738-744. doi: 10.1080/23744235.2019.1646431. Epub 2019 Jul 31.

Abstract

Background: We aimed to investigate the clinical, laboratory, microbiological characteristics of IE in a single tertiary care centre in Turkey and to identify the factors associated with in-hospital mortality. Methods: A total of 155 consecutive adult patients (≥18 years) admitted to our single tertiary care hospital between 2009 and 2019 with definite infective endocarditis were retrospectively included in the study. Results: The mean age of the patients was 58 years. Among 155 endocarditis episodes, 60% involved prosthetic valves, 35.5% had native valve endocarditis (NVE) and 4.5% were device related. Prosthetic valve disease was the most frequent predisposing valve lesion followed by degenerative valvular disease. Vegetations were detected in 103 (66.5%) patients by transthoracic echocardiography and in 145 (93%) patients by transoesophageal echocardiography. The most commonly affected valve was the mitral valve in 84 (54.2%) patients, followed by 67 (43.2%) aortic valve. Staphylococci were the most frequent causative microorganisms isolated in both NVE (31.8%), prosthetic valve endocarditis (38.9%) and device related IE cases. At least one complication was present in 70 patients (45.2%). One hundred and eight patients underwent surgical therapy (69.7%). Age, syncope, heart failure, perforation, septic shock, renal failure, high red cell distribution width, atrial fibrillation, hypocalcaemia, pulmonary hypertension were associated with high mortality. Conclusions: We identified a 10-year presentation of IE in a referral centre in Turkey. Likely other series, we observed more staphylococcus endocarditis with the aging of the population. Surgery was associated with higher in-hospital survival. Age, syncope, perforation, septic shock were independent predictors of mortality.

Keywords: Infective endocarditis; epidemiology; mortality.

MeSH terms

  • Adult
  • Aged
  • Endocarditis / diagnosis
  • Endocarditis / epidemiology*
  • Endocarditis / microbiology
  • Endocarditis / mortality
  • Endocarditis, Bacterial / diagnosis
  • Endocarditis, Bacterial / epidemiology*
  • Endocarditis, Bacterial / microbiology
  • Endocarditis, Bacterial / mortality
  • Female
  • Humans
  • Immunocompromised Host
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Tertiary Care Centers / statistics & numerical data
  • Turkey / epidemiology