Patients with infective endocarditis referred to Division of Cardiovascular and Pulmonary Diseases at Oslo University Hospital between 2014 and 2017. (3rd July 2020)

• Record Type: Journal Article
• Authors: Muthiah, Anujan; Beitnes, Jan Otto; Skulstad, Helge
• Is Part Of: Scandinavian cardiovascular journal. Volume 54:Number 4(2020)
• Page Start: 258
• Page End: 264
• Publication Date: 2020-07-03
• Subjects: Infective endocarditis -- prosthetic valve -- streptococci -- staphylococci -- echocardiography -- surgery -- surgical indication -- mortality; Cardiovascular system -- Diseases -- Periodicals; 617.41
• DOI: 10.1080/14017431.2020.1734232
• Languages: English
• ISSNs: 1401-7431

Abstract

Abstract: Objectives. Infective endocarditis has potential for severe complications and high mortality. The number of patients with prosthetic valves has risen, and an increase in incidence of infective endocarditis has been suggested. We aimed to examine the epidemiology, etiology, treatment and outcome of patients admitted to Division of Cardiovascular and Pulmonary Diseases at Oslo University Hospital, and explore changes in incidence over the last four years. Design. We conducted a retrospective study including all patients admitted to a tertiary hospital in Oslo, Norway, and diagnosed with infective endocarditis according to ICD-10 between 2014 and 2017. Results. Two hundred and ninety-one patients ≥18 years were included (61.3 ± 13.8 years, 75.6% men). 36.4% had previous valve surgery and this proportion decreased during the period. The aortic valve was most commonly affected (51.9%). Streptococci were the most frequent microorganisms (35.1%), while staphylococci accounted for 26.8%. 81.8% were treated surgically, at a median of 6.5 (0–120) days after admission. Hemodynamic changes or instability was the primary surgical indication (51.5%). One-year mortality was 20.6%. Surgery within a week after admission resulted in poorer 1-year prognosis than surgery after one week. Also, surgically treated patients who died were significantly older than those who survived. Conclusions. In this cohort, streptococci were the most common causative microorganism. Approximately, one-third of the patients had prosthetic valves. Mortality remains high, underscoring the need for continuous medical awareness. A high number of streptococcus infections in this cohort suggest dental origin.