title: Current Epidemiology and Outcome of Infective Endocarditis: A Multicenter, Prospective, Cohort Study.
abstract: The aim of the study was to describe the epidemiologic and clinical characteristics and identify the risk factors of short-term and 1-year mortality in a recent cohort of patients with infective endocarditis (IE).From January 2008, multidisciplinary teams have prospectively collected all consecutive cases of IE, diagnosed according to the Duke criteria, in 25 Spanish hospitals.Overall, 1804 patients were diagnosed. The median age was 69 years (interquartile range, 55-77), 68.0% were men, and 37.1% of the cases were nosocomial or health care-related IE. Gram-positive microorganisms accounted for 79.3% of the episodes, followed by Gram-negative (5.2%), fungi (2.4%), anaerobes (0.9%), polymicrobial infections (1.9%), and unknown etiology (9.1%). Heart surgery was performed in 44.2%, and in-hospital mortality was 28.8%. Risk factors for in-hospital mortality were age, previous heart surgery, cerebrovascular disease, atrial fibrillation, Staphylococcus or Candida etiology, intracardiac complications, heart failure, and septic shock. The 1-year independent risk factors for mortality were age (odds ratio [OR], 1.02), neoplasia (OR, 2.46), renal insufficiency (OR, 1.59), and heart failure (OR, 4.42). Surgery was an independent protective factor for 1-year mortality (OR, 0.44).IE remains a severe disease with a high rate of in-hospital (28.9%) and 1-year mortality (11.2%). Surgery was the only intervention that significantly reduced 1-year mortality.
authors.affiliation: From the Hospital General Universitario Gregorio Marañon (PM, MK, JB, HR-A, EB), Madrid; Medicine Department (PM, MK, JB, HR-A, EB), School of Medicine, Universidad Complutense de Madrid; H Valdecilla (MCF, MCB), Santander; Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva. Hospital, Universitario Virven del Rocío, Sevilla (ADA), Sevilla; H Clinic-IDIBAPS (JMM, CM), University of Barcelona, Barcelona; Complejo Hospitalario Universitario A Coruña (PL), A Coruña; H Donosti Policlinica Gipuzkoa (MG), San Sebastián; H Ramón y Cajal (EN), Madrid; H San Pedro (JAO), La Rioja; Hospital Universitario de Álava, sede Txagorritxu (PT), Vitoria; and CIBER de Enfermedades Respiratorias-CIBERES (CB06/06/0058) (EB, PM), Madrid, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Muñoz
authors.forename: Martha
authors.initials: M
authors.lastname: Kestler
authors.forename: Arístides
authors.initials: A
authors.lastname: De Alarcon
authors.forename: José María
authors.initials: JM
authors.lastname: Miro
authors.forename: Javier
authors.initials: J
authors.lastname: Bermejo
authors.forename: Hugo
authors.initials: H
authors.lastname: Rodríguez-Abella
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Fariñas
authors.forename: Manuel
authors.initials: M
authors.lastname: Cobo Belaustegui
authors.forename: Carlos
authors.initials: C
authors.lastname: Mestres
authors.forename: Pedro
authors.initials: P
authors.lastname: Llinares
authors.forename: Miguel
authors.initials: M
authors.lastname: Goenaga
authors.forename: Enrique
authors.initials: E
authors.lastname: Navas
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Oteo
authors.forename: Paola
authors.initials: P
authors.lastname: Tarabini
authors.forename: Emilio
authors.initials: E
authors.lastname: Bouza
mesh_terms: D000368:Aged; D004696:Endocarditis / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality*; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality*; D006350:Heart Valve Prosthesis / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology