[Infectious endocarditis: prognostic factors of mortality in 131 cases].
BACKGROUND
Global hospital mortality for infective endocarditis ranges from 13 to 40%.


OBJECTIVE
To compare clinical, microbiological, echocardiographic factors and complications between patients that died during an episode of infective endocarditis and those who survived.


METHODS
We followed during their hospital stay, 129 patients, aged 14 to 74 years old, who had 131 episodes of infective endocarditis. Clinical assessment, echocardiography and microbiological study was done to all patients. Surgical indications were those derived from complications.


RESULTS
Thirty three patients died during hospital stay (25.2%). There were no differences between survivors and deceased patients in the lapse between onset of symptoms and hospital admission, presence of fever, dyspnea or heart murmurs. Skin and mucosal septic manifestations occurred with higher frequency in deceased patients (57.1 and 24.3% respectively). Blood cultures were positive in 55% in survivors and 48% in those who died. The most frequent infecting organisms were staphilococci and streptococci. Vegetations were found with greater frequency in aortic position in both groups of patients. Deceased patients had a higher frequency of cardiac failure (84 and 65% respectively) and embolic episodes (77 and 46% respectively) than survivors. Antimicrobial treatment was successful in 94% of survivors and 15% of those who died. Forty percent of survivors and 54% of deceased patients were subjected to surgical procedures.


CONCLUSIONS
The most important predictor of hospital mortality in this series of patients with infective endocarditis was antimicrobial treatment failure.
Oyonarte
M
M
Departamento de Medicina Interna, Hospital Clínico San Borja Arriarán, Santiago de Chile.
Rojo
P
P
Estévez
A
A
Solís
I
I
Akel
C
C
Klenner
C
C
Cumsille
J F
JF
D000293:Adolescent; D000328:Adult; D000368:Aged; D004697:Endocarditis, Bacterial / Q000150:complications / Q000401:mortality* / Q000628:therapy; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies