title: Influence of diabetes mellitus on the clinical manifestations and prognosis of infective endocarditis: a report from the International Collaboration on Endocarditis-Merged Database.
abstract: The purpose of this investigation was to study the influence of diabetes mellitus (DM) on outcomes of infective endocarditis (IE). Outcomes were compared between 150 diabetic and 905 non-diabetic patients with IE from the International Collaboration on Endocarditis Merged Database. Compared to non-diabetic patients, diabetic patients were older (median age 63 vs 57 y, p<0.001), were more often female (42.0% vs 31.9%, p=0.01), more often had comorbidities (41.5% vs 26.7%, p<0.001), and were more likely to be dialysis dependent (12.7% vs 4.0%, p<0.001). S. aureus was isolated more often (30.7% vs 21.7%, p=0.02), and microorganisms from the viridans Streptococcus group less often (16.7% vs 28.2%, p = 0.001) in the diabetic group. There was no difference with respect to the presence of congestive heart failure, embolism, intra-cardiac abscess, new valvular regurgitation, or valvular vegetation. Diabetic patients underwent surgical intervention less frequently (32.0% vs 44.9%, p = 0.003), and had higher overall in-hospital mortality (30.3% vs 18.6%, p = 0.001). On multivariable analysis, DM was an independent predictor of mortality (odds ratio (OR) = 1.71, 95% confidence interval (CI) 1.08-2.70), especially in male patients, as diabetic males had higher mortality than non-diabetic males (OR 2.18, CI 1.08-4.35). DM is an independent predictor of in-hospital mortality among patients hospitalized with IE.
authors.affiliation: Duke University Medical Center, Durham, NC, USA.
authors.forename: Wissam M
authors.initials: WM
authors.lastname: Kourany
authors.forename: Jose M
authors.initials: JM
authors.lastname: Miro
authors.forename: Asuncion
authors.initials: A
authors.lastname: Moreno
authors.forename: G Ralph
authors.initials: GR
authors.lastname: Corey
authors.forename: Paul A
authors.initials: PA
authors.lastname: Pappas
authors.forename: Elias
authors.initials: E
authors.lastname: Abrutyn
authors.forename: Bruno
authors.initials: B
authors.lastname: Hoen
authors.forename: Gilbert
authors.initials: G
authors.lastname: Habib
authors.forename: Vance G
authors.initials: VG
authors.lastname: Fowler
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Sexton
authors.forename: Lars
authors.initials: L
authors.lastname: Olaison
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Cabell
mesh_terms: D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000382:microbiology*; D004452:Echocardiography; D004696:Endocarditis / Q000150:complications* / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000150:complications / Q000453:epidemiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D014481:United States / Q000453:epidemiology