Endocarditis-TR: Diagnosis, treatment, and prognosis of the infective endocarditis patients admitting tertiary centres of Turkey.

Autor: Çalık AN; Department of Cardiology, Faculty of Medicine, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, İstanbul, Turkey., Özlük ÖA; Department of Cardiology, Faculty of Medicine, Bursa Yüksek İhtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey., Karataş MB; Department of Cardiology, Faculty of Medicine, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, İstanbul, Turkey., Çanga Y; Department of Cardiology, Faculty of Medicine, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, İstanbul, Turkey., Eren S; Department of Cardiology, Faculty of Medicine, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, İstanbul, Turkey., Ayhan G; Department of Cardiology, Faculty of Medicine, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, İstanbul, Turkey., Akdeniz A; Department of Cardiology, Faculty of Medicine, Bursa Yüksek İhtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey., Palice A; Department of Cardiology, Faculty of Medicine, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, İstanbul, Turkey., Candemir A; Department of Cardiology, Faculty of Medicine, Ege University, İzmir, Turkey., Akyüz Ş; Department of Cardiology, Faculty of Medicine, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, İstanbul, Turkey., Zoghi M; Department of Cardiology, Faculty of Medicine, Ege University, İzmir, Turkey., Kozan Ö; Department of Cardiology, Faculty of Medicine, Başkent University, İstanbul, Turkey.
Jazyk: angličtina
Zdroj: Turkish journal of medical sciences [Turk J Med Sci] 2022 Apr; Vol. 52 (2), pp. 445-455. Date of Electronic Publication: 2022 Apr 14.
DOI: 10.55730/1300-0144.5332
Abstrakt: Background: Infective endocarditis (IE) is still a significant cause of morbidity and mortality among cardiovascular diseases. ENDOCARDITIS-TR study aims to evaluate the compliance of the diagnostic and therapeutic methods being used in Turkey with current guidelines.
Methods: The ENDOCARDITIS-TR trial is a multicentre, prospective, observational study consisting of patients admitted to tertiary centres with a definite diagnose of IE. In addition to the demographic, clinical, microbiological, and echocardiographic findings of the patients, adverse events, indications for surgery, and in-hospital mortality were recorded during a 2-year time interval.
Results: A total of 208 IE patients from 7 tertiary centres in Turkey were enrolled in the study. The study population included 125 (60.1%) native valve IE (NVE), 65 (31.3%) prosthetic IE (PVIE), and 18 (8.7%) intracardiac device-related IE (CDRIE). One hundred thirty-five patients (64.9%) were culture positive, and the most frequent pathogenic agent was methicillin-susceptible Staphylococcus aureus (MSSA) (18.3%). Among 155 (74.5%) patients with an indication for surgery, only 87 (56.1%) patients underwent surgery. The all-cause mortality rate was 29.3% in-hospital follow-up. Multivariable Cox regression analysis revealed that absence of surgery when indicated (HR: 3.29 95% CI: 0.93-11.64 p = 0.05), albumin level at admission (HR: 0.46 95% CI: 0.29-0.73 P < 0.01), abscess formation (HR: 2.11 95% CI: 1.01-4.38 p = 0.04) and systemic embolism (HR: 1.78 95% CI: 1.05-3.02 p = 0.03) were ascertained independent predictors of in-hospital all-cause mortality.
Discussion: The short-term results of the ENDOCARDITIS-TR trial showed the high frequency of staphylococcal IE, relatively high in-hospital mortality rates, shortage of surgical treatment despite guideline-based surgical indications and low usage of novel imaging techniques. The results of this study will provide a better insight to physicians in respect to their adherence to clinical practice guidelines.
Databáze: MEDLINE
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