ENDOCARDITIS-TR: Diagnosis, Treatment and Prognosis of the Infective Endocarditis Patients Admitting Tertiary Centers of Turkey
| Autor: | Çalik A.N., Özlük Ö.A., Karataş M.B., Çanga Y., Eren S., Ayhan G., Akdeniz A. |
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| Rok vydání: | 2021 |
| Předmět: |
all cause mortality
methicillin susceptible Staphylococcus aureus heart valve disease abscess bacterium culture heart failure mortality rate embolism Article computer assisted tomography transthoracic echocardiography male albumin level echocardiography follow up human transesophageal echocardiography adult clinical trial General Medicine therapy effect bacterial endocarditis major clinical study heart surgery hospital admission female multicenter study blood sampling observational study Infective endocarditis in-hospital mortality |
| Zdroj: | TURKISH JOURNAL OF MEDICAL SCIENCES. |
| ISSN: | 1303-6165 |
| DOI: | 10.3906/sag-2105-118 |
| Popis: | Background/aim: 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. Materials and 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. Conclusion: 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. © TÜBİTAK. |
| Databáze: | OpenAIRE |
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