Abstract

MELO, Luís et al. Infective Endocarditis: Review of All Cases in an Internal Medicine Department Over a 6 Year Period. Medicina Interna [online]. 2017, vol.24, n.1, pp.19-23. ISSN 0872-671X.

Introduction:Despite an improvement in diagnostic and therapeutic procedures, infective endocarditis still carries a high mortality and morbidity that has been unchanged for the last 30 years. There has been a recent epidemiological shift translated by an increase of prevalence in older patients, without the characteristic risk factors. This audit aims at analysing the characteristics of the patients admitted to the Internal Medicine wards due to infective endocarditis in a six year period. Methods: We selected all the cases coded as infective endocarditis admitted to the Internal Medicine ward in the period from 01/01/2009 to 31/12/2014. Clinical data was obtained from the electronic medical records. Results: We identified 40 cases (in 39 patients-32 men and seven women, medium age 62.3 years), which fulfilled the modified Duke’s criteria. Twenty-eight (70.0%) patients had native-valve endocarditis, five (12.5%) had prosthetic-valve involvement and two (5.0%) had vegetations elsewhere. Blood cultures were positive in 31 (77.5%) patients. Twenty-eight (70.0%) patients had complications, with valvular regurgitation in 15 (53.5%). Surgical intervention was required in 16 (40.0%) patients. Medium-time to diagnosis was 8.1 days. The average duration of in-hospital stay was 24.37 ± 31.68 days, with an in-hospital mortality of 17.5% (seven patients). Conclusion: Our analysis reflects the reported epidemiologic shift with an increased incidence in older patients with a more severe presentation at admission. There was an increased incidence in an older population, which had more co-morbidities and a more serious clinical presentation

Keywords : Comorbidity; Endocarditis; Bacterial/diagnosis; Endocarditis; Bacterial/epidemiology; Heart Failure; Risk Factors.

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