Prognostic factors of infective endocarditis in patients on hemodialysis: A case series from a National Multicenter Registry.

Autor: Ramos-Martínez A; Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain. Electronic address: aramos220@gmail.com., Roque F; Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain. Electronic address: fernando.roque89@gmail.com., Fariñas MC; Servicio de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain. Electronic address: mcfarinas@humv.es., Muñoz P; Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Facultad de Medicina, Universidad Complutense de Madrid, Spain. Electronic address: pmunoz@micro.hggm.es., Verde E; Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain. Electronic address: eduardo.verde@salud.madrid.org., Cuerpo GP; Servicio de Cirugía Cardiaca, Hospital General Universitario Gregorio Marañón, Madrid, Spain. Electronic address: grepa_genf@yahoo.es., de Alarcón A; Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBIS), University of Seville/CSIC/University Virgen del Rocío and Virgen Macarena, Seville, Spain. Electronic address: aa2406ge@yahoo.es., Lepe JA; Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBIS), University of Seville/CSIC/University Virgen del Rocío and Virgen Macarena, Seville, Spain. Electronic address: jalepe@cica.es., Miró JM; Servicio de Enfermedades Infecciosas, Hospital Clinic de Barcelona-IDIBAPS, Universidad de Barcelona, Barcelona, Spain. Electronic address: josemaria@miromoreno.org., Plata A; Servicio de Enfermedades Infecciosas, Hospital Regional Universitario de Málaga, Málaga, Spain. Electronic address: antonio-plata@hotmail.com., Goenaga MÁ; Servicio de Enfermedades Infecciosas, Hospital Universitario Donosti, San Sebastián, Spain. Electronic address: goenagasanchez@gmail.com., García-Rosado D; Sección de Infecciones del Hospital Universitario de Canarias, Santa Cruz de Tenerife, Islas Canarias, Spain. Electronic address: dacilrosado@hotmail.com., Martínez-Monzonis A; Servicio de Cardiología, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, Spain. Electronic address: alfg@secardiologia.es., de la Torre J; Infectious Diseases Group, Department of Internal Medicine, Hospital Costa del Sol, Marbella, Spain. Electronic address: jtorrel@gmail.com., García-Pavía P; Department of Cardiology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain; Francisco de Vitoria University, Madrid, Spain. Electronic address: pablogpavia@yahoo.es.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2017 Aug 15; Vol. 241, pp. 295-301. Date of Electronic Publication: 2017 Apr 29.
DOI: 10.1016/j.ijcard.2017.04.086
Abstrakt: Background: Infective endocarditis (IE) is a severe complication associated with high mortality.
Objectives: To examine the clinical characteristics of IE in hemodialysis (HD) patients and to determine prognostic factors related to HD.
Methods: From January 2008 to April 2015, 2488 consecutive patients with definite IE were included. Clinical characteristics of IE patients on HD were compared with those of IE patients who were not on HD.
Results: A total of 126 patients (63% male, median age: 66years; IQR: 54-74years) with IE (5.1%) were on HD. Fifty-two patients died during hospitalization (41%) and 17 additional patients (14%) died during the first year. The rate of patients who underwent surgery during hospitalization was lower in HD patients (38 patients, 30%) than in non-HD patients (1177 patients, 50%; p<0.001). Age >70years (OR: 4.1, 95% CI: 1.7-10), heart failure (OR: 3.3, 95% CI: 1.4-7-6), central nervous system (CNS) vascular events (OR: 6.7, 95% CI: 2.1-22) and septic shock (OR: 4.1, 95% CI: 1.4-12.1) were independently associated with fatal outcome in HD patients. Of the 38 patients who underwent surgery, 15 (39.5%) died during hospitalization.
Conclusions: HD patients with IE present a high mortality. Advanced age and complications, such as heart failure, CNS stroke or septic shock, are associated with mortality.
(Copyright © 2017 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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