Infective endocarditis: mid-term prognosis in patients with good in-hospital outcome.
OBJECTIVE
The study aim was to analyze the mid-term prognosis of infective endocarditis (IE) in patients managed with medical therapy during the in-hospital phase and who had a good initial outcome. Comparison was made with the prognosis of patients treated surgically during this period.


METHODS
A total of 151 patients diagnosed with IE was studied, and in-hospital outcome, clinical characteristics and mid-term follow up data were analyzed. The main end-point was a composite of death and need for surgical repair.


RESULTS
Among 151 patients, 84 (56%) underwent surgery or died during the in-hospital phase, while 67 patients (44%) received medical treatment and were discharged clinically stable with a final diagnosis of healed infective endocarditis. A better baseline profile was seen in the medically treated group, but outcome in this group showed extensive mid-term morbidity/mortality. In total, 52.2% of patients underwent surgery to correct complications and 60% died as a consequence of the disease. The event-free survival rate was 20% at five years.


CONCLUSIONS
Despite a favorable in-hospital clinical course and successful medical treatment, patients with IE are at risk of late complications that result in a need for surgical repair, or in death. A close follow up should be made in order to treat late complications.
Unidad de Ecocardiografía e Imagen Cardiaca, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain. jlzamorano@vodafone.es
José
J
Zamorano
Leopoldo Pérez
LP
de Isla
Gracieta
G
Malangatana
Carlos
C
Almería
José Luis
JL
Rodrigo
Adalia
A
Aubele
Isidre
I
Vilacosta
Enrique
E
Rodriguez
Carlos
C
Macaya
D017541:Aneurysm, False / Q000209:etiology; D018572:Disease-Free Survival; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology; D006351:Heart Valves / Q000601:surgery; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome