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Infective endocarditis at a tertiary care hospital in South Korea.

Authors :
Jung Ho Kim
Lee, Hi Jae
Nam Su Ku
Lee, Seung Hyun
Lee, Sak
Jun Yong Choi
Joon-Sup Yeom
Kim, Jung Ho
Ku, Nam Su
Choi, Jun Yong
Yeom, Joon-Sup
Source :
Heart; 1/15/2021, Vol. 107 Issue 2, p135-141, 7p
Publication Year :
2021

Abstract

<bold>Objective: </bold>The treatment of infective endocarditis (IE) has become more complex with the current myriad healthcare-associated factors and the regional differences in causative organisms. We aimed to investigate the overall trends, microbiological features, and outcomes of IE in South Korea.<bold>Methods: </bold>A 12-year retrospective cohort study was performed. Poisson regression was used to estimate the time trends of IE incidence and mortality rate. Risk factors for in-hospital mortality were identified with multivariable logistic regression, and model comparison was performed to evaluate the predictive performance of notable risk factors. Kaplan-Meier survival analysis and Cox regression were performed to assess long-term prognosis.<bold>Results: </bold>We included 419 patients with IE, the incidence of which showed an increasing trend (relative risk 1.06, p=0.005), whereas mortality demonstrated a decreasing trend (incidence rate ratio 0.93, p=0.020). The in-hospital mortality rate was 14.6%. On multivariable logistic regression analysis, aortic valve endocarditis (OR 3.18, p=0.001), IE caused by Staphylococcus aureus (OR 2.32, p=0.026), neurological complications (OR 1.98, p=0.031), high Sequential Organ Failure Assessment score (OR 1.22, p=0.023) and high Charlson Comorbidity Index (OR 1.11, p=0.019) were predictors of in-hospital mortality. Surgical intervention for IE was a protective factor against in-hospital mortality (OR 0.25, p<0.001) and was associated with improved long-term prognosis compared with medical treatment only (p<0.001).<bold>Conclusions: </bold>The incidence of IE is increasing in South Korea. Although the mortality rate has slightly decreased, it remains high. Surgery has a protective effect with respect to both in-hospital mortality and long-term prognosis in patients with IE. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
13556037
Volume :
107
Issue :
2
Database :
Complementary Index
Journal :
Heart
Publication Type :
Academic Journal
Accession number :
147760555
Full Text :
https://doi.org/10.1136/heartjnl-2020-317265