Infective endocarditis: Clinical features and prognosis between 2004 and 2014 in a non-teaching hospital

• Published in: Annales de cardiologie et d'angeiologie Vol. 66; no. 2; p. 87
• Main Authors: Capilla, E, Poyet, R, Tortat, A-V, Marchi, J, Brocq, F-X, Pons, F, Kerebel, S, Jego, C, Mayet, A, Cellarier, G R
• Format: Journal Article
• Language: French
• Published: France 01.04.2017
• Subjects: Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Echocardiography - methods; Echocardiography, Transesophageal - methods; Endocarditis - diagnosis; Endocarditis - drug therapy; Endocarditis - microbiology; Endocarditis - mortality; Female; Hospitals, General; Humans; Male; Middle Aged; Retrospective Studies; Risk Factors; Staphylococcal Infections - complications; Staphylococcal Infections - diagnosis; Staphylococcal Infections - drug therapy; Staphylococcal Infections - mortality; Staphylococcus aureus - isolation & purification; Treatment Outcome; Endocardite infectieuse liée aux soins; Facteurs pronostiques; Partnership practice; Health care-associated infective endocarditis; Infective endocarditis; Endocardite infectieuse; Partenariat; Prognostic factors; Staphylococcus
• ISSN: 1768-3181
• DOI: 10.1016/j.ancard.2016.09.042

Despite diagnostic and therapeutic advances, infective endocarditis (IE) remains a severe disease. The aim of the study was to describe clinical features and prognosis of patients with IE in a non-teaching hospital and compare them with current data and a similar study conducted 10 years earlier in the same center. We performed a single institution retrospective study including all patients with Duke-Li definite IE between 2004 and 2014. Ninety-four patients were included. Results are consistent with current French and international data, including in-hospital death rate of 16%. In accordance with literature, we report on an increase in Staphylococcus and health care-associated IE and endocarditis on pacemaker leads, but without significant difference compared to our previous study. In univariate analyses, renal failure, age over 77 years and Staphylococcus aureus IE were associated with in-hospital mortality. In multivariate analyses, predictors of in-hospital death were renal failure and lack of surgery. There was a non-significant trend of excess mortality in Staphylococcus endocarditis and in patients with heart failure. IE remains a severe disease and S. aureus is more often involved. IE seems to be safely managed in a peripheral hospital provided that there is a partnership with a reference hospital.