title: [Infectious endocarditis in the intensive care unit].
abstract: OBJECTIVE
  To study the characteristics, evolution and prognosis of patients with infectious endocarditis requiring treatment in the Intensive Care Unit.
  
  
  METHODS
  A prospective, observational cohort study of patients admitted due to infectious endocarditis.
  
  
  METHODS
  Nuestra Señora de Candelaria University Hospital, a third - level center with a recruitment population of 493,145.
  
  
  METHODS
  All patients consecutively diagnosed with infectious endocarditis in our center according to the Duke criteria, between 1 January 2005 and 31 July 2011.
  
  
  METHODS
  Demographic data, clinical severity scores, microbiological and echocardiographic data, hospital mortality and complications.
  
  
  RESULTS
  Out of 102 patients diagnosed with endocarditis, 38 (37%) were admitted to Intensive Care. Compared with those patients not admitted to the ICU, these subjects suffered more frequent mitral valve alterations (OR= 7.13; 95%CI: 2.12-24; p= 0.002) and cerebral embolism (OR= 3.89; 95%CI: 1.06-14.3; p= 0.041). In turn, mortality was greater (42.1% vs 18.8%, p= 0.011), as was the proportion of emergency surgeries (45.8% vs 5.9%, p<0.001). The identified mortality predictors were Staphylococcus aureus infection (OR= 3.49; 95%CI 1.02-11.93; p=0.046), heart failure (OR=4.18; 95%CI: 1.17-14.94; p=0.028), cerebral embolism (OR= 8.45; 95%CI: 1.89-37.74; p=0.005) and the SAPS II upon admission (OR=1.09; 95%CI: 1.04-1.15; p<0.001).
  
  
  CONCLUSIONS
  A large proportion of patients with endocarditis require admission to the Intensive Care Unit, presenting a much poorer prognosis. Staphylococcus aureus infection, heart failure, cerebral embolism and SAPS II scores are independent predictors of hospital mortality.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Ntra. Sra. de Candelaria, Santa Cruz de Tenerife, España. simirmon@hotmail.com
authors.forename: S
authors.initials: S
authors.lastname: Miranda-Montero
authors.forename: M
authors.initials: M
authors.lastname: Rodríguez-Esteban
authors.forename: L
authors.initials: L
authors.lastname: Alvarez-Acosta
authors.forename: S
authors.initials: S
authors.lastname: Lubillo-Montenegro
authors.forename: H
authors.initials: H
authors.lastname: Pérez-Hernández
authors.forename: R
authors.initials: R
authors.lastname: Llorens-León
mesh_terms: D015331:Cohort Studies; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000401:mortality; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies