title: Influence of diabetes mellitus on short- and long-term outcome in patients with active infective endocarditis.
abstract: OBJECTIVE
  The incidence and severity of certain infections appear to be increased in patients with diabetes mellitus (DM). The study aim was to evaluate the effect of DM on short- and long-term outcome in patients with active infective endocarditis (IE).
  
  
  METHODS
  A total of 151 patients with IE was included and followed up for a mean of 3.1 years. Of these patients, 13 (9%) were diabetics. The outcome of patients with or without DM was compared at short-term (in-hospital) and long-term follow up.
  
  
  RESULTS
  Patients with DM were older (66 +/- 11 versus 50 +/- 19 years, p < 0.01) and had a lower frequency of intravenous drug abuse (0 versus 30%, p <0.01) and tricuspid valve involvement (0 versus 20%, p = 0.02) than non-DM patients. Mortality was higher in DM patients both in hospital (31% versus 15%, p = NS) and at a mean follow up of 3.1 years (54% versus 31%, p = 0.002). DM patients also had a significantly higher rate of cardiac failure (69% versus 38%, p = 0.03) and renal failure (62% versus 20%, p <0.01) during hospitalization. Incidences of anatomic complications (abscess, pseudoaneurysm) (15.4% versus 20.3%), valve rupture or perforation (7.7% versus 16.7%) and need for surgical repair (46.2% versus 45.7%) were similar in both DM and non-DM patients. DM, without secondary pathology like renal failure, did not appear to be an independent risk factor for mortality at either short- or long-term follow up.
  
  
  CONCLUSIONS
  Although mortality and morbidity in IE were greater in DM than in non-DM patients, diabetes itself does not constitute an independent risk factor.
mesh_terms: D000328:Adult; D000368:Aged; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000401:mortality; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors