[Infective endocarditis in two Spanish university hospitals in different geographical locations with and without a cardiac surgery department].
OBJECTIVE
To assess possible differences in clinical presentation, microbiology, morbidity and mortality of infective endocarditis between two Spanish hospitals, one on the mainland that has cardiac surgery and one in the Canary Islands without this service.


METHODS
A total of 229patients consecutively diagnosed of endocarditis between 2005 and 2012, including pediatric population, were studied in the Reina Sofía Hospital (Córdoba, n=119) and Nuestra Señora de Candelaria Hospital (Tenerife, n=110). We compared the clinical, microbiological and echocardiographic data and analyzed mortality differences by binary logistic regression analysis.


RESULTS
There were no differences in underlying heart disease, proportion of surgery, or the microbiological profile. The proportion of infections attributable to catheter was higher in the Canary Islands hospital (13.6% vs 3.4%). Mortality was also higher (31.8% vs 18.5%, P=.020), although this difference was no longer significant in the multivariate analysis (OR=1.85; 95%CI, 0.70-4.87; P=.213). Age (OR=1.04/year; 95%CI, 1.01-1.07; P=.006), cardiac complications (OR=5.05; 95%CI, 1.78-14.34; P=.002), persistent sepsis (OR=4.89; 95%CI, 2.09-11.46; P<.001), and emergent surgery (OR=4.43, 95%CI, 1.75-11.19; P=.002) were independent predictors of death. Time to surgery, length of stay in the hospital without a surgical service (20 [13-30.5] vs 13 [6-25] days; P=.019) was not associated with outcome.


CONCLUSIONS
There are differences in the presentation of endocarditis between two distant hospitals in Spain. The different hospital mortality can not be directly related to the presence of a surgery service.
Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España. Electronic address: mrodest@gmail.com.
Marcos
M
Rodríguez-Esteban
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
Manuel
M
Anguita
Unidad de Medicina Intensiva, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España.
Sara
S
Miranda-Montero
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
Juan Carlos
JC
Castillo
Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España.
Luis
L
Alvarez-Acosta
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
Francisco
F
Castillo
Servicio de Cirugía Cardiaca, Hospiten Rambla, Santa Cruz de Tenerife, España.
Rafael
R
Llorens-León
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
José
J
Suárez-de Lezo
D000368:Aged; D004696:Endocarditis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006748:Hospital Departments; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain; D013903:Thoracic Surgery
Endocarditis; Epidemiology; Epidemiología; Población; Population; Prognosis; Pronóstico