Document Detail


Is the clinical spectrum and prognosis of native valve infective endocarditis in non-addicts changing?
MedLine Citation:
PMID:  8881865     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
One hundred and ninety-four episodes of endocarditis on native valves in non-addict patients were diagnosed from 1975 to 1992 and were divided into groups A (78 patients, 1975-1983) and B (116 patients 1984-1992). Both groups had the same gender distribution, similar valvular involvement and microbiological characteristics. In group B patients, median age was older (46 vs 54 years, P = 0.0002), the number of patients without previous heart disease was higher (46% vs 22%, P = 0.02) and the median time of symptoms before diagnosis was shorter (30 vs 50 days, P = 0.038). Both groups had similar incidence of heart failure (32% vs 36%), surgical treatment (30% vs 33%) and embolic episodes (26% vs 34%). Surgical mortality decreased from 43% to 18% (P = 0.03). Overall mortality decreased non-significantly from 19% in group A to 12% in group B. Predictors of death in group A were heart failure (odds ratio 9.6, 95% confidence interval 3-36) and surgical treatment (odds ratio 5, 95% confidence interval 1.3-19). Predictors of death in group B were age (odds ratio 4.98, 95% confidence interval 1.4-19), female sex (odds ratio 5.3, 95% confidence interval 1.3-20), staphylococcal infection (odds ratio 4.9, 95% confidence interval 1.1-22) and heart failure (odds ratio 5.2, 95% confidence interval 1.3-20). Although in recent years infective endocarditis occurs in older patients and is more common in patients with previously unknown heart disease a substantial change in major clinical and prognostic variables is not apparent in our population. Overall in-hospital mortality has decreased from 19% to 12% mainly due to better surgical results.
Authors:
M P Tornos; M Olona; G Permanyer-Miralda; B Almirante; A Evangelista; J Soler-Soler
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  16     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1995 Nov 
Date Detail:
Created Date:  1996-12-17     Completed Date:  1996-12-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1686-91     Citation Subset:  IM    
Affiliation:
Servicio de Cardiología, Hospital General Universitario Vall d'Hebron, Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Cardiac Output, Low / etiology
Child
Endocarditis, Bacterial / epidemiology,  physiopathology*,  surgery
Female
Hospital Mortality
Humans
Male
Middle Aged
Prognosis
Retrospective Studies
Sex Factors
Substance-Related Disorders
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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