Contemporary epidemiology of infective endocarditis in patients with congenital heart disease: A UK prospective study
| Autor: | L Denne, Thomas J. Cahill, A Frigiola, RC Franklin, E Orchard, P D Jewell, Bernard Prendergast |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Heart Defects Congenital Male medicine.medical_specialty Pediatrics Heart disease Adolescent 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences Young Adult 0302 clinical medicine Bicuspid aortic valve Risk Factors Epidemiology medicine Prevalence Humans cardiovascular diseases 030212 general & internal medicine Hospital Mortality Prospective Studies Prospective cohort study Child Tetralogy of Fallot Endocarditis business.industry Incidence (epidemiology) Incidence Infant Staphylococcal Infections medicine.disease United Kingdom Survival Rate Infective endocarditis Child Preschool Population Surveillance Female Cardiology and Cardiovascular Medicine Complication business Follow-Up Studies |
| Zdroj: | American heart journal. 215 |
| ISSN: | 1097-6744 |
| Popis: | Infective endocarditis is a life-threatening complication of congenital heart disease (CHD), but there are few studies concerning the contemporary risk profile, preceding invasive procedures and outcomes in this patient population. The aim of this study was to investigate the epidemiology of infective endocarditis (IE) in patients with CHD.Cases of IE in children and adults with CHD were prospectively recorded as part of the UK National Institute for Cardiovascular Outcomes Research (NICOR) National Congenital Heart Disease Audit. Patients were entered into the database between April 2008 and March 2016.Eight hundred episodes of IE were recorded in 736 patients with CHD. Sixty-five patients (9%) were infants (aged1 year), 235 (32%) were children (aged 1-15 years), and 436 (59%) were adults (aged15 years). The most common diagnoses were Tetralogy of Fallot (n = 150, 22.8%), ventricular septal defect (n = 129, 19.6%) and bicuspid aortic valve (n = 70, 10.7%). Dental procedures preceded 67 of 635 episodes (11%) of IE, and non-dental invasive procedures preceded 177 of 644 episodes (27.4%). The most common causative organisms were streptococci, accounting for 40% of cases. Overall in-hospital mortality was 6.7%. On multivariable analysis, adverse factors associated with in-hospital mortality were staphylococcal infection and presence of an underlying atrioventricular septal defect.Infective endocarditis in patients with CHD is an ongoing clinical challenge. In contemporary practice in tertiary congenital centers, 1 of 15 patients do not survive to hospital discharge. Streptococci remain the most common causative organism, and antecedent dental or medical procedures were undertaken in a significant minority in the 3 months before diagnosis. The presence of an atrioventricular septal defect or staphylococcal infection is associated with significantly increased risk of early mortality. |
| Databáze: | OpenAIRE |
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