Clinical and echocardiographic risk factors for embolism and mortality in infective endocarditis
- 16 July 2008
- journal article
- Published by Springer Science and Business Media LLC in European Journal of Clinical Microbiology & Infectious Diseases
- Vol. 27 (12), 1159-1164
- https://doi.org/10.1007/s10096-008-0572-9
Abstract
Data about predictors of embolism in patients with infective endocarditis (IE) are conflicting. This study aimed to investigate clinical and transoesophageal echocardiography (TEE) characteristics in predicting embolism and six-month mortality. In this observational cohort study, 216 patients with definite left-sided IE, according to the modified Duke criteria, were prospectively recruited. All patients underwent TEE. ‘Any embolism’ was defined as embolism before or after initiation of antimicrobial therapy; ‘new embolism’ included embolism after initiation of antimicrobial therapy. Sixty-two of 216 patients (29%) experienced any embolism. New embolism occurred in 12 patients (6%), 7 of which were postoperative. Factors significantly associated with any embolism were community origin of IE and the etiologic microorganism, in particular staphylococci and nonviridans streptococci. Vegetation length >10 mm showed a trend towards association with new embolism and a mobile vegetation was predictive for new embolism. Six-month mortality was 24% (52/216). In multivariable analysis, age, vegetation length >10 mm, Staphylococcus aureus, and the type of treatment predicted mortality. Multiple emboli showed a trend towards association with death. In conclusion, any embolism occurred in over a fourth of patients. A mobile vegetation was significantly associated with new embolism, and vegetation length >10 mm tended to be associated with new embolism. Vegetation length >10 mm predicted six-month mortality, and multiple emboli showed a trend towards association with death.Keywords
This publication has 19 references indexed in Scilit:
- Neurological Outcome of Septic Cardioembolic Stroke After Infective EndocarditisStroke, 2006
- Infective endocarditis: changing epidemiology and predictors of 6-month mortality: a prospective cohort studyEuropean Heart Journal, 2006
- Management of Adult Stroke Rehabilitation CareStroke, 2005
- Risk of Embolism and Death in Infective Endocarditis: Prognostic Value of EchocardiographyCirculation, 2005
- Infective EndocarditisCirculation, 2005
- Infective EndocarditisCirculation, 2005
- Early Predictors of In-Hospital Death in Infective EndocarditisCell Metabolism, 2004
- Hospital‐Acquired Infective Endocarditis: Should the Definition be Broadened?Clinical Infectious Diseases, 2004
- Risk factors for systemic emboli in infective endocarditisClinical Microbiology & Infection, 2004
- Echocardiography in infective endocarditis: Reassessment of prognostic implications of vegetation size determined by the transthoracic and the transesophageal approachJournal of the American College of Cardiology, 1989