Infective endocarditis treated in a secondary hospital: epidemiological, clinical, microbiological characteristics and prognosis, with special reference to patients transferred to a third level hospital
Autor: | E. García Vázquez, J. Gómez Gómez, A. Peláez Ballesta |
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Rok vydání: | 2021 |
Předmět: |
Male
Microbiology (medical) Staphylococcus aureus medicine.medical_specialty Delayed Diagnosis Original medicine.drug_class Antibiotics cirugía surgery tratamiento Pharmacotherapy Internal medicine Epidemiology medicine Humans Hospital Mortality Heart valve endocarditis infecciosa Retrospective Studies Pharmacology Endocarditis infective endocarditis business.industry Mortality rate Endocarditis Bacterial General Medicine Middle Aged Prognosis medicine.disease Hospitals drug therapy medicine.anatomical_structure Heart failure Infective endocarditis Cohort Female business |
Zdroj: | Revista Española de Quimioterapia |
ISSN: | 1988-9518 0214-3429 2000-2017 |
Popis: | Introduction. To analyse the clinical and epidemiological characteristics and mortality-related factors of patients admitted to a secondary hospital with Infective Endocarditis (IE). Methods. Observational study of a cohort of patients who have been diagnosed with IE in a secondary hospital and evaluated in accordance with a pre-established protocol. Results. A total of 101 cases were evaluated (years 2000-2017), with an average age of 64 years and a male-to-female ratio of 2:1. 76% of the cases had an age-adjusted Charlson comorbidity index of >6, with 21% having had a dental procedure and 36% with a history of heart valve disease. The most common microorganism was methicillin-susceptible S. aureus (36%), with bacterial focus of unknown origin in 54%. The diagnostic delay time was 12 days in patients who were transferred, compared to 8 days in patients who were not transferred (p=0.07); the median surgery indication delay time was 5 days (IQR 13.5). The in-hospital mortality rate was 34.6% and the prognostic factors independently associated with mortality were: cerebrovascular events (OR 98.7%, 95% CI, 70.9–164.4); heart failure (OR 27.3, 95% CI, 10.2–149.1); and unsuitable antibiotic treatment (OR 7.2, 95% CI, 1.5–10.5). The mortality rate of the patients who were transferred and who therefore underwent surgery was 20% (5/25). Conclusions. The onset of cerebrovascular events, heart failure and unsuitable antibiotic treatment are independently and significantly associated with in-hospital mortality. The mortality rate was higher than the published average (35%); the diagnostic delay was greater in patients for whom surgery was indicated. |
Databáze: | OpenAIRE |
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