Short-term and one-year outcome of infective endocarditis in adult patients treated in a Finnish teaching hospital during 1980-2004.
BACKGROUND
Previous studies on factors predicting the prognosis of infective endocarditis have given somewhat conflicting results. Our aim was to define the factors predicting the outcome of patients treated in a Finnish teaching hospital.


METHODS
A total of 326 episodes of infective endocarditis in 303 patients treated during 1980-2004 were evaluated for short-term and 1-year outcome and complications.


RESULTS
Infection of 2 native valves and the occurrence of neurological complications, peripheral emboli, or heart failure significantly predicted both in-hospital and 1-year mortality, while age > or =65 years or the presence of a major criterion or vegetation on echocardiography predicted death within 1 year. A significant trend was observed between the level of serum C-reactive protein (CRP) on admission and both the short-term and 1-year outcome. In the patients who had CRP values > or =100 mg/l on admission, the hazard ratio for in-hospital death was 2.9-fold and the hazard ratio for 1-year death was 3.9-fold as compared to those with lower CRP values. Male sex and age < 64 years significantly predicted a need for both in-hospital and 1-year surgery, as did the development of heart failure or the presence of a major criterion or vegetation on echocardiography. Peripheral emboli were associated with a need for in-hospital surgery, while Streptococcus pneumoniae as the causative agent or infection of 2 native valves predicted a need for surgery within 1 year from admission.


CONCLUSIONS
Some of the factors (e.g. heart failure, neurological complications, peripheral emboli) predicting a poor prognosis and/or need for surgery were the same observed in previous studies. A new finding was that high CRP values (> or =100 mg/l) on admission significantly predicted both short-term and 1-year mortality.
Heiro
Maija
M
Department of Medicine, Turku University Hospital, Turku, Finland. maija.heiro@tyks.fi <maija.heiro@tyks.fi>
Helenius
Hans
H
Hurme
Saija
S
Savunen
Timo
T
Engblom
Erik
E
Nikoskelainen
Jukka
J
Kotilainen
Pirkko
P
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004617:Embolism / Q000150:complications / Q000382:microbiology; D004697:Endocarditis, Bacterial / Q000150:complications / Q000382:microbiology / Q000401:mortality*; D005260:Female; D005387:Finland; D006349:Heart Valve Diseases / Q000150:complications / Q000382:microbiology / Q000401:mortality* / Q000601:surgery; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications / Q000382:microbiology; D011379:Prognosis; D012737:Sex Factors; D015996:Survival Rate