Maria Carmo Pereira Nunes1, Milton Henriques Guimarães-Júnior2, Pedro Henrique Oliveira Murta Pinto2, Rodrigo Matos Pinto Coelho3, Thais Lins Souza Barros2, Nicole de Paula Aarão Faleiro Maia2, Dayane Amaral Madureira2, Rodrigo Citton Padilha Reis4, Paulo Henrique Nogueira Costa2, Renato Bráulio2, Cláudio Léo Gelape2, Teresa Cristina Abreu Ferrari5. 1. Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Department of Cardiology and Cardiovascular Surgery of the Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. Electronic address: mcarmo@waymail.com.br. 2. Department of Cardiology and Cardiovascular Surgery of the Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. 3. Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. 4. Department of Statistics, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. 5. Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Department of Cardiology and Cardiovascular Surgery of the Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Abstract
BACKGROUND: The early identification of patients at risk of complications of infective endocarditis (IE) using parameters obtained as part of routine practice is essential for guiding clinical decision-making. This study aimed to identify a parameter at hospital admission that predicts the outcome, adding value to other well-known factors of a poor prognosis in IE. METHODS: Two hundred and three patients with IE were included in this study. Clinical evaluation, echocardiography, blood cultures, and routine laboratory tests were performed at hospital admission. The endpoint was in-hospital mortality. RESULTS: The mean age of the patients was 48.2±16.6 years; 62% were male and 38% had rheumatic heart disease. During treatment, cardiac surgery was performed in 111 patients (55%), and the overall in-hospital mortality rate was 32%. In the multivariable analysis, the independent predictors of death were age (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.02-1.13), C-reactive protein (CRP) at hospital admission (OR 1.12, 95% CI 1.04-1.21), length of the vegetation at diagnosis (OR 1.15, 95% CI 1.03-1.28), development of heart failure (OR 6.43, 95% CI 2.14-19.33), and embolic events during antimicrobial therapy (OR 12.14, 95% CI 2.11-71.89). CONCLUSIONS: An elevated CRP level at hospital admission and vegetation length at diagnosis were strong predictors of in-hospital mortality in IE, independent of other prognostic parameters, specifically taking into account patient characteristics and complications during therapy.
BACKGROUND: The early identification of patients at risk of complications of infective endocarditis (IE) using parameters obtained as part of routine practice is essential for guiding clinical decision-making. This study aimed to identify a parameter at hospital admission that predicts the outcome, adding value to other well-known factors of a poor prognosis in IE. METHODS: Two hundred and three patients with IE were included in this study. Clinical evaluation, echocardiography, blood cultures, and routine laboratory tests were performed at hospital admission. The endpoint was in-hospital mortality. RESULTS: The mean age of the patients was 48.2±16.6 years; 62% were male and 38% had rheumatic heart disease. During treatment, cardiac surgery was performed in 111 patients (55%), and the overall in-hospital mortality rate was 32%. In the multivariable analysis, the independent predictors of death were age (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.02-1.13), C-reactive protein (CRP) at hospital admission (OR 1.12, 95% CI 1.04-1.21), length of the vegetation at diagnosis (OR 1.15, 95% CI 1.03-1.28), development of heart failure (OR 6.43, 95% CI 2.14-19.33), and embolic events during antimicrobial therapy (OR 12.14, 95% CI 2.11-71.89). CONCLUSIONS: An elevated CRP level at hospital admission and vegetation length at diagnosis were strong predictors of in-hospital mortality in IE, independent of other prognostic parameters, specifically taking into account patient characteristics and complications during therapy.
Authors: T Ris; A Teixeira-Carvalho; R Matos Pinto Coelho; C Brandao-de-Resende; M Souza Gomes; L Rodrigues Amaral; P H Oliveira Murta Pinto; L J Souza Santos; J Teixeira Salles; Jolien Roos-Hesselink; N Verkaik; T Cristina Abreu Ferrari; M C Pereira Nunes Journal: Clin Exp Immunol Date: 2019-02-17 Impact factor: 4.330
Authors: María Isabel Biezma; Patricia Muñoz; Sofía De la Villa; Mª Carmen Fariñas-Álvarez; Francisco Arnáiz de Las Revillas; Encarnación Gutierrez-Carretero; Arístides De Alarcón; Raquel Rodríguez-García; Jaume Llopis; Miguel Ángel Goenaga; Andrea Gutierrez-Villanueva; Antonio Plata; Laura Vidal; Manuel Martínez-Sellés Journal: J Clin Med Date: 2022-05-09 Impact factor: 4.241
Authors: José M de Miguel-Yanes; Rodrigo Jiménez-García; Valentín Hernández-Barrera; Javier de Miguel-Díez; Manuel Méndez-Bailón; Nuria Muñoz-Rivas; Napoleón Pérez-Farinós; Ana López-de-Andrés Journal: Cardiovasc Diabetol Date: 2019-11-21 Impact factor: 9.951