Infective endocarditis in the intensive care unit: clinical spectrum and prognostic factors in 228 consecutive patients View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2004-09-15

AUTHORS

Bruno Mourvillier, Jean-Louis Trouillet, Jean-François Timsit, Jérome Baudot, Jean Chastre, Bernard Régnier, Claude Gibert, Michel Wolff

ABSTRACT

ObjectiveTo identify factors associated with in-hospital outcome of adult patients admitted to the ICU with infective endocarditis (IE).Design and settingRetrospective study performed in the two medical ICUs of a teaching hospital.Patients and participantsThe charts of all 228 consecutive patients aged 18 years or older admitted with infective IE between January 1993 and December 2000 were reviewed. All patients satisfied the modified Duke’s criteria for definite IE.Measurements and resultsThere were 146 episodes of native valve endocarditis and 82 of prosthetic valve endocarditis. Staphylococcus aureus was the predominant causative micro-organism. Most complications occurred early during the course of IE. One-half of the patients underwent cardiac surgery during the same hospitalization and had a better outcome than nonoperated patients. The overall in-hospital mortality rate was 45% (102/228). Multivariate analysis revealed the following clinical factors in patients with native valve IE as independently associated with outcome: septic shock (odds ratio 4.81), cerebral emboli (3.00), immunocompromised state (2.88), and cardiac surgery (0.475); in patients with prosthetic valve IE the factors were: septic shock (4.07), neurological complications (3.1), and immunocompromised state (3.46).ConclusionsIE still carries high morbidity and mortality rates for the subset of patients requiring ICU admission. Most complications occur early making the decision process for optimal medical and surgical management more difficult. Surgical treatment appears to improve in-hospital outcome. More... »

PAGES

2046-2052

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00134-004-2436-9

DOI

http://dx.doi.org/10.1007/s00134-004-2436-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1012488023

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/15372147


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