[Infectious endocarditis. A study of 50 patients in a non-university hospital].
The authors report the results of a single centre study of 50 consecutive patients (average age 66 +/- 14 years; 36 men), admitted between 1992 and 2001 to a peripheral hospital for infectious endocarditis (IE). The median interval to diagnosis was 57 days. There was an underlying cardiac disease in 52% of cases, usually valvular (42%). The site of the IE was the mitral valve in 21 cases, the aortic valve in 19 cases, mitro-aortic valves in 5 cases, native tricuspid valves in 2 cases and pacing catheters in 4 cases (associated with valvular endocarditis in one patient). The causal organism was usually a streptococcus (60%, including 28% of streptococcus bovis), or a staphylococcus (22%): no organism could be found in 7 patients. The average follow-up was 33 +/- 30 months: surgery was indicated in half the patients and 3 patients were turned down because of their poor general condition. In all, 34% of patients died (24% of their IE) in a median interval of 6 months, mainly from infectious or haemodynamic complications. Poor prognostic factors were: age > 70 years, "blind" antibiotic therapy, large-sized vegetations, embolism and renal failure. These data, comparable to the results observed in large series in the literature, underline the importance of multi-disciplinary management of IE and strict prophylaxis.
Service de cardiologie, HIA Sainte-Anne, boulevard Sainte-Anne, 83800 Toulon Naval. gcellarier@wanadoo.fr
G
G
Cellarier
P
P
Laurent
Ch
Ch
Jégo
F
F
Barbou
O
O
Gisserot
J
J
Bonal
Ch
Ch
Bouchiat
G V
GV
Dussarat
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D005602:France; D006439:Hemodynamics; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents