Publication
Left-sided infective endocarditis: analysis of in-hospital and medium-term outcome and predictors of mortality
| dc.contributor.author | Ferreira, J. | |
| dc.contributor.author | Gomes, F. | |
| dc.contributor.author | Rodrigues, P. | |
| dc.contributor.author | Araújo Abreu, M. | |
| dc.contributor.author | Maia, J. | |
| dc.contributor.author | Bettencourt, P. | |
| dc.contributor.author | Luz, A. | |
| dc.contributor.author | Torres, S. | |
| dc.contributor.author | Araújo Correia, J. | |
| dc.date.accessioned | 2014-04-23T12:14:54Z | |
| dc.date.available | 2014-04-23T12:14:54Z | |
| dc.date.issued | 2013-10 | |
| dc.description.abstract | Abstract Introduction: Despite diagnostic and therapeutic advances, infective endocarditis (IE) remains a challenging and potentially lethal disease. The prognosis of IE remains poor; in the last 30 years, its incidence and mortality have only been marginally reduced. Early identification of high-risk patients can change the course of the disease and improve outcomes. Objectives and methods: To describe and investigate predictors of mortality during hospital stay and in the six months after discharge in a cohort of left-sided IE patients in two tertiary centers. All patients diagnosed with IE (ICD9 code 133) were registered in a uniform database. Results: One hundred and forty-seven consecutive case patients with left-sided IE were included in this study. Thirty-five patients (23.8%) died during hospital stay. The variables significantly associated with increased mortality in univariate analysis were Charlson index ≥5, use of immunosuppressants, sepsis (severe sepsis and/or septic shock), cardiogenic shock and inappropriate use of antibiotic therapy. Conversely, surgical therapy and hospital length of stay ≥30 days were significantly associated with lower mortality. In multivariate analysis the most important predictors of in-hospital mortality were sepsis (severe and/or shock), use of immunosuppressants and inappropriate use of antibiotic therapy. There was a significant relation between the use of immunosuppressants and the occurrence of sepsis. The presence of significant valve disease after IE significantly increased the risk of heart failure. Conclusions: Our results may help to identify IE patients at increased risk for in-hospital mortality and medium-term disability. These findings can help to identify candidates for earlier and more aggressive management. | por |
| dc.identifier.uri | http://hdl.handle.net/10400.16/1602 | |
| dc.language.iso | eng | en |
| dc.peerreviewed | yes | por |
| dc.publisher | Elsevier | por |
| dc.relation.publisherversion | http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90252423&pident_usuario=0&pcontactid=&pident_revista=334&ty=162&accion=L&origen=elsevierpt%20&web=www.elsevier.pt&lan=en&fichero=334v32n10a90252423pdf001.pdf | por |
| dc.subject | Infective | por |
| dc.subject | endocarditis | por |
| dc.subject | Outcome | por |
| dc.subject | Analysis | por |
| dc.subject | Mortality | por |
| dc.title | Left-sided infective endocarditis: analysis of in-hospital and medium-term outcome and predictors of mortality | por |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.title | Revista Portuguesa de Cardiologia | por |
| oaire.citation.volume | Rev Port Cardiol. 2013;32(10):777---784 | por |
| rcaap.rights | openAccess | por |
| rcaap.type | article | por |