Serious complications after infective endocarditis.
BACKGROUND
The objective of the present study was to review all cases of infective endocarditis at our hospital between 2002 and 2006 concerning the bacteriological aetiology and outcomes.


METHODS
This is a retrospective study based on medical records from patients in whom the discharge diagnosis infective endocarditis was established according to Duke's criteria. The study included 151 patients.


RESULTS
The most prominent risk factors were valvular prostheses (22%) and known valvular disease (21%). The median diagnostic delay was four days (0-103 days). The most prominent causative microorganism was Staphylococcus aureus (41%), followed by non-haemolytic streptococci (21%), haemolytic streptococci (10%) and enterococci (14%). The most frequently occurring complications were embolic events (29%) and valvular insufficiency (26%). Renal insufficiency, multi-organic failure and disseminated intravascular coagulation occurred in 36 patients (24%). Half of the patients (51%) received surgical treatment. The overall in-hospital mortality was 29%, and 16% had severe sequelae at discharge. High mortality was found, particularly in the elderly patients, in patients who had staphylococcal endocarditis and in patients with valvular prosthesis.


CONCLUSIONS
Despite considerable progress in diagnostics and treatment facilities, infective endocarditis remains a serious disease with long diagnostic delay times, high complication rates and a high mortality.
Cardiology Department, Odense University Hospital, 5000 Odense C, Denmark.
Van
V
Le
Sabine
S
Gill
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057210:Delayed Diagnosis; D003718:Denmark; D004452:Echocardiography; D004696:Endocarditis / Q000150:complications* / Q000382:microbiology / Q000401:mortality; D005260:Female; D006305:Health Status Indicators; D006349:Heart Valve Diseases / Q000150:complications*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013211:Staphylococcus aureus / Q000302:isolation & purification; D055815:Young Adult