Cumulative incidence and mortality of infective endocarditis in Siriraj hospital–Thailand: a 10-year retrospective study
Abstract Background To investigate the cumulative incidence of and factors associated with mortality among patients with infective endocarditis (IE) at Thailand’s largest national tertiary referral center. Methods Medical charts of adult patients diagnosed with IE by Duke criteria at Siriraj Hospita...
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doaj-a4e681f43c1c4ea08570cce14f3ffb0c2020-12-20T12:05:54ZengBMCBMC Infectious Diseases1471-23342019-12-011911910.1186/s12879-019-4689-5Cumulative incidence and mortality of infective endocarditis in Siriraj hospital–Thailand: a 10-year retrospective studyTaksaon Angsutararux0Nasikarn Angkasekwinai1Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityAbstract Background To investigate the cumulative incidence of and factors associated with mortality among patients with infective endocarditis (IE) at Thailand’s largest national tertiary referral center. Methods Medical charts of adult patients diagnosed with IE by Duke criteria at Siriraj Hospital during January 2005 to May 2015 were retrospectively reviewed. Results Of 380 patients, 66.3% had definite IE, and 81.3% had native valve IE (NVE). Cumulative IE incidence was 5.67/1000 admissions. The most common pathogens were viridans group streptococci (VGS) (39.7%), methicillin-sensitive Staphylococcus aureus (MSSA) (13.1%), and beta-hemolytic streptococci (11.5%) in NVE; and, MSSA (20.3%), VGS (20.3%), and Enterococcus spp. (16.9%) in prosthetic valve (PVE) or device-related IE (DRIE). Overall in-hospital mortality was 18.4%. Mortality was significantly higher in PVE/DRIE than in NVE (26.8% vs. 16.5%, p = 0.047). End-stage renal disease (ESRD) (aOR: 9.43, 95% CI: 2.36–37.70), diabetes mellitus (DM) (aOR: 2.81, 95% CI: 1.06–7.49), neurological complication (aOR: 14.16, 95% CI: 5.11–39.22), congestive heart failure (aOR: 4.32, 95% CI: 1.91–9.75), hospital-acquired infection (aOR: 3.78, 95% CI: 1.66–8.57), renal complication (aOR: 3.12, 95%CI: 1.32–7.37), and other complication during admission (aOR: 3.28, 95% CI: 1.41–7.61) were independently associated with mortality. Conclusions The incidence of IE, and the mortality rate among those diagnosed with IE are both increasing in Thailand – particularly among those with PVE or DRIE. End-stage renal disease, diabetes mellitus, and development of IE-related complications during admission were found to be independent predictors of mortality.https://doi.org/10.1186/s12879-019-4689-5Infective endocarditisIENative valve IEProsthetic valve IE |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Taksaon Angsutararux Nasikarn Angkasekwinai |
spellingShingle |
Taksaon Angsutararux Nasikarn Angkasekwinai Cumulative incidence and mortality of infective endocarditis in Siriraj hospital–Thailand: a 10-year retrospective study BMC Infectious Diseases Infective endocarditis IE Native valve IE Prosthetic valve IE |
author_facet |
Taksaon Angsutararux Nasikarn Angkasekwinai |
author_sort |
Taksaon Angsutararux |
title |
Cumulative incidence and mortality of infective endocarditis in Siriraj hospital–Thailand: a 10-year retrospective study |
title_short |
Cumulative incidence and mortality of infective endocarditis in Siriraj hospital–Thailand: a 10-year retrospective study |
title_full |
Cumulative incidence and mortality of infective endocarditis in Siriraj hospital–Thailand: a 10-year retrospective study |
title_fullStr |
Cumulative incidence and mortality of infective endocarditis in Siriraj hospital–Thailand: a 10-year retrospective study |
title_full_unstemmed |
Cumulative incidence and mortality of infective endocarditis in Siriraj hospital–Thailand: a 10-year retrospective study |
title_sort |
cumulative incidence and mortality of infective endocarditis in siriraj hospital–thailand: a 10-year retrospective study |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2019-12-01 |
description |
Abstract Background To investigate the cumulative incidence of and factors associated with mortality among patients with infective endocarditis (IE) at Thailand’s largest national tertiary referral center. Methods Medical charts of adult patients diagnosed with IE by Duke criteria at Siriraj Hospital during January 2005 to May 2015 were retrospectively reviewed. Results Of 380 patients, 66.3% had definite IE, and 81.3% had native valve IE (NVE). Cumulative IE incidence was 5.67/1000 admissions. The most common pathogens were viridans group streptococci (VGS) (39.7%), methicillin-sensitive Staphylococcus aureus (MSSA) (13.1%), and beta-hemolytic streptococci (11.5%) in NVE; and, MSSA (20.3%), VGS (20.3%), and Enterococcus spp. (16.9%) in prosthetic valve (PVE) or device-related IE (DRIE). Overall in-hospital mortality was 18.4%. Mortality was significantly higher in PVE/DRIE than in NVE (26.8% vs. 16.5%, p = 0.047). End-stage renal disease (ESRD) (aOR: 9.43, 95% CI: 2.36–37.70), diabetes mellitus (DM) (aOR: 2.81, 95% CI: 1.06–7.49), neurological complication (aOR: 14.16, 95% CI: 5.11–39.22), congestive heart failure (aOR: 4.32, 95% CI: 1.91–9.75), hospital-acquired infection (aOR: 3.78, 95% CI: 1.66–8.57), renal complication (aOR: 3.12, 95%CI: 1.32–7.37), and other complication during admission (aOR: 3.28, 95% CI: 1.41–7.61) were independently associated with mortality. Conclusions The incidence of IE, and the mortality rate among those diagnosed with IE are both increasing in Thailand – particularly among those with PVE or DRIE. End-stage renal disease, diabetes mellitus, and development of IE-related complications during admission were found to be independent predictors of mortality. |
topic |
Infective endocarditis IE Native valve IE Prosthetic valve IE |
url |
https://doi.org/10.1186/s12879-019-4689-5 |
work_keys_str_mv |
AT taksaonangsutararux cumulativeincidenceandmortalityofinfectiveendocarditisinsirirajhospitalthailanda10yearretrospectivestudy AT nasikarnangkasekwinai cumulativeincidenceandmortalityofinfectiveendocarditisinsirirajhospitalthailanda10yearretrospectivestudy |
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