Cerebral emboli as the predictor of mortality in patients with definite infective endocarditis
Infective endocarditis (IE) is among the most fatal infectious diseases. Since the introduction of various intracardiac devices and interventions, the clinical aspects of IE have rapidly evolved. In this paper, we aim to define the contemporary characteristics of patients diagnosed with definite IE...
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| Format: | Article |
| Language: | English |
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Society of Turaz Bilim
2021-09-01
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| Series: | Medicine Science |
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| Online Access: | http://www.ejmanager.com/fulltextpdf.php?mno=39679 |
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| author | Demet Ozkaramanli Gur Nurullah Uslu Aydin Akyuz Seref Alpsoy Ozcan Gur Mustafa Dogan Mustafa Hakan Dinckal1 Selami Gurkan |
| author_facet | Demet Ozkaramanli Gur Nurullah Uslu Aydin Akyuz Seref Alpsoy Ozcan Gur Mustafa Dogan Mustafa Hakan Dinckal1 Selami Gurkan |
| author_sort | Demet Ozkaramanli Gur |
| collection | DOAJ |
| description | Infective endocarditis (IE) is among the most fatal infectious diseases. Since the introduction of various intracardiac devices and interventions, the clinical aspects of IE have rapidly evolved. In this paper, we aim to define the contemporary characteristics of patients diagnosed with definite IE and to identify the predictors associated with mortality. Through retrospective analysis of patients with TEE proven vegetation, those fulfilling the modified Duke criteria for definite IE were identified. Patient characteristics in relation to clinical outcomes and mortality were analyzed. Out of 50 patients (mean age 57±15.9 years, 34% female), 72% was native-valve endocarditis of which only 32% had a predisposing valve disease such as rheumatic valve. The rate of prosthetic-valve IE was 10% and that of device-related IE was 18%. The most common causative organisms were S. aureus (16%), Coagulase-negative Staphylococci (16%), Enterococci (14%) and Viridans streptococci (12%). In-hospital mortality was 24% and was associated with concomitant diabetes, coronary artery disease, higher baseline creatinine, anemia, occurrence of cranial complications and absence of surgery during the index hospitalization. Regression analyses revealed that cerebral emboli were the only predictor of early mortality, possibly through delayed surgical treatment. In conclusion, our small cohort of definite IE patients showed that contemporary characteristics of IE has evolved with higher rates of device-related IE. Within established prognostic factors, cerebral emboli and timing of surgery are intervening factors, which suggests that the timing of surgical treatment, particularly in patients with neurologic complications, needs to be evaluated when shaping future perspectives on IE. [Med-Science 2021; 10(3.000): 839-45] |
| first_indexed | 2024-03-08T07:04:19Z |
| format | Article |
| id | doaj.art-0d417214f7b948a39e485db949ed67d2 |
| institution | Directory Open Access Journal |
| issn | 2147-0634 |
| language | English |
| last_indexed | 2024-03-08T07:04:19Z |
| publishDate | 2021-09-01 |
| publisher | Society of Turaz Bilim |
| record_format | Article |
| series | Medicine Science |
| spelling | doaj.art-0d417214f7b948a39e485db949ed67d22024-02-03T05:06:15ZengSociety of Turaz BilimMedicine Science2147-06342021-09-011038394510.5455/medscience.2021.01.0139679Cerebral emboli as the predictor of mortality in patients with definite infective endocarditisDemet Ozkaramanli Gur0Nurullah Uslu1Aydin Akyuz2Seref Alpsoy3Ozcan Gur4Mustafa Dogan5Mustafa Hakan Dinckal16Selami Gurkan7Namik Kemal University Faculty of Medicine Namik Kemal University Faculty of Medicine Namik Kemal University Faculty of Medicine Namik Kemal University Faculty of Medicine Namik Kemal University Faculty of Medicine Namik Kemal University Faculty of Medicine Namik Kemal University Faculty of Medicine Namik Kemal University Faculty of MedicineInfective endocarditis (IE) is among the most fatal infectious diseases. Since the introduction of various intracardiac devices and interventions, the clinical aspects of IE have rapidly evolved. In this paper, we aim to define the contemporary characteristics of patients diagnosed with definite IE and to identify the predictors associated with mortality. Through retrospective analysis of patients with TEE proven vegetation, those fulfilling the modified Duke criteria for definite IE were identified. Patient characteristics in relation to clinical outcomes and mortality were analyzed. Out of 50 patients (mean age 57±15.9 years, 34% female), 72% was native-valve endocarditis of which only 32% had a predisposing valve disease such as rheumatic valve. The rate of prosthetic-valve IE was 10% and that of device-related IE was 18%. The most common causative organisms were S. aureus (16%), Coagulase-negative Staphylococci (16%), Enterococci (14%) and Viridans streptococci (12%). In-hospital mortality was 24% and was associated with concomitant diabetes, coronary artery disease, higher baseline creatinine, anemia, occurrence of cranial complications and absence of surgery during the index hospitalization. Regression analyses revealed that cerebral emboli were the only predictor of early mortality, possibly through delayed surgical treatment. In conclusion, our small cohort of definite IE patients showed that contemporary characteristics of IE has evolved with higher rates of device-related IE. Within established prognostic factors, cerebral emboli and timing of surgery are intervening factors, which suggests that the timing of surgical treatment, particularly in patients with neurologic complications, needs to be evaluated when shaping future perspectives on IE. [Med-Science 2021; 10(3.000): 839-45]http://www.ejmanager.com/fulltextpdf.php?mno=39679definite infective endocarditiscerebral embolisurgery |
| spellingShingle | Demet Ozkaramanli Gur Nurullah Uslu Aydin Akyuz Seref Alpsoy Ozcan Gur Mustafa Dogan Mustafa Hakan Dinckal1 Selami Gurkan Cerebral emboli as the predictor of mortality in patients with definite infective endocarditis Medicine Science definite infective endocarditis cerebral emboli surgery |
| title | Cerebral emboli as the predictor of mortality in patients with definite infective endocarditis |
| title_full | Cerebral emboli as the predictor of mortality in patients with definite infective endocarditis |
| title_fullStr | Cerebral emboli as the predictor of mortality in patients with definite infective endocarditis |
| title_full_unstemmed | Cerebral emboli as the predictor of mortality in patients with definite infective endocarditis |
| title_short | Cerebral emboli as the predictor of mortality in patients with definite infective endocarditis |
| title_sort | cerebral emboli as the predictor of mortality in patients with definite infective endocarditis |
| topic | definite infective endocarditis cerebral emboli surgery |
| url | http://www.ejmanager.com/fulltextpdf.php?mno=39679 |
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