Prosthetic valve endocarditis in a multicenter registry of Chinese patients.
We evaluated the clinical outcomes of prosthetic valve endocarditis in 2 major tertiary referral centers in Hong Kong. The study population comprised 80 consecutive Chinese patients who fulfilled the modified Duke criteria for prosthetic valve endocarditis from March 2000 to June 2007. The major clinical endpoints analyzed were hospital mortality, need for valve surgery, and relapse of prosthetic endocarditis. The mean age at presentation was 56 ± 13 years, with a slight male preponderance. There were 76 (95%) patients with involvement of a mechanical prosthesis; the majority (69%) had late prosthetic endocarditis. Major hospital complications occurred in 49 (61%) patients. The overall hospital mortality was 28% (22 patients). Thirty-four (42%) patients required valve surgery during index hospitalization, of whom 5 (15%) died due to uncontrolled sepsis. Factors associated with hospital mortality were older age at presentation, Staphylococcus aureus infection, embolic events, severe heart failure, valve surgery, and any major complication. On multivariate analysis, severe heart failure was the only independent predictor of hospital death. Among the 58 hospital survivors followed up for a mean of 48 ± 31 months, 6 (10%) developed late complications related to prosthetic valve endocarditis, with 5 documented cases of relapse.
Cardiac Medical Unit, Grantham Hospital, Aberdeen, Hong Kong, China. hokai_wah@yahoo.com
Hee-Hwa
HH
Ho
Chung-Wah
CW
Siu
Kai-Hang
KH
Yiu
Hung-Fat
HF
Tse
Wing-Hung
WH
Chui
Wing-Hing
WH
Chow
D000328:Adult; D000368:Aged; D002681:China; D004697:Endocarditis, Bacterial / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D012008:Recurrence; D012042:Registries; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome