Infective endocarditis in a Finnish teaching hospital: a study on 326 episodes treated during 1980–2004. Issue 10 (27th April 2006)

• Record Type: Journal Article
• Authors: Heiro, M; Helenius, H; Mäkilä, S; Hohenthal, U; Savunen, T; Engblom, E; Nikoskelainen, J; Kotilainen, P
• Is Part Of: Heart. Volume 92:Issue 10(2006)
• Page Start: 1457
• Page End: 1462
• Publication Date: 2006-04-27
• Subjects: IE, infective endocarditis -- IVDU, intravenous drug use -- TOE, transoesophageal echocardiography -- TTE, transthoracic echocardiography; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2005.084715
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objectives: To evaluate potential changes of infective endocarditis (IE) in patients treated in a Finnish teaching hospital during the past 25 years. Patients: 326 episodes of IE in 303 patients treated during 1980–2004 were evaluated for clinical characteristics and their changes over time. Results: The mean age of the patients increased with time (from 47.2 to 54.5 years, p = 0.003). Twenty-five (7.7%) episodes were associated with intravenous drug use (IVDU), with a significant increase of these episodes after 1996 (from 0 to 19 (20%), p < 0.001). Viridans streptococci were the most common causative agents of IE during 1980–1994, but after that Staphylococcus aureus was the most common pathogen (p = 0.015). The proportion of IE of the aortic valve decreased during the study (from 30 (49%) to 26 (27%), whereas the proportions of mitral (11 (18%) to 33 (35%) and tricuspid valve IE (0 to 13 (14%) increased correspondingly (p = 0.001). This was mainly due to more patients with IVDU. Chronic dialysis for renal failure as an underlying condition increased over time (from 0 to 7 (7.4%), p = 0.015) but no other predisposing conditions changed. Complications such as neurological manifestations and heart failure did not change in frequency, but the incidence of lung emboli increased (from 0% to 10.5%, p < 0.001); 83% of these emboli occurred in patients with IVDU. The proportion of patients requiring surgical treatment and mortality due to IE did not change. Conclusions: During these 25 years, the causative agents, affected valves and complications of IE changed to some degree. These changes were mainly attributed to the increase of IVDU-associated IE. Except for the increase in age, the clinical presentation and outcome in non-addicts remained substantially unchanged.