Risk Factors Associated with Poor Outcome in Patients with Infective Endocarditis: An Italian Single-Center Experience
Abstract
:1. Introduction
2. Materials and Methods
3. Results
Study Population
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Bennett, J.; Dolin, R.; Blaser, M. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 9th ed.; Elsevier: Amsterdam, The Netherlands, 2019. [Google Scholar]
- The 2015 ESC Guidelines for the management of infective endocarditis. Eur. Heart J. 2015, 36, 3036–3037. [CrossRef] [Green Version]
- Iversen, K.; Ihlemann, N.; Gill, S.U.; Madsen, T.; Elming, H.; Jensen, K.T.; Bruun, N.E.; Høfsten, D.E.; Fursted, K.; Christensen, J.J.; et al. Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis. N. Engl. J. Med. 2019, 380, 415–424. [Google Scholar] [CrossRef] [PubMed]
- Mancino, P.; Ucciferri, C.; Falasca, K.; Pizzigallo, E.; Vecchiet, J. Methicillin-resistant Staphylococcus epidermidis (MRSE) endocarditis treated with linezolid. Scand. J. Infect. Dis. 2008, 40, 67–73. [Google Scholar] [CrossRef] [PubMed]
- Yeager, S.D.; Oliver, J.E.; Shorman, M.A.; Wright, L.R.; Veve, M.P. Comparison of linezolid step-down therapy to standard parenteral therapy in methicillin-resistant Staphylococcus aureus bloodstream infections. Int. J. Antimicrob. Agents 2021, 57, 106329. [Google Scholar] [CrossRef] [PubMed]
- Rezar, R.; Jirak, P.; Lichtenauer, M.; Jung, C.; Lauten, A.; Hoppe, U.C.; Wernly, B. Partial oral antibiotic therapy is non-inferior to intravenous therapy in non-critically ill patients with infective endocarditis. Wien. Klin. Wochenschr. 2020, 132, 762–769. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Martí-Carvajal, A.J.; Dayer, M.; O Conterno, L.; Garay, A.G.G.; Martí-Amarista, C.E. A comparison of different antibiotic regimens for the treatment of infective endocarditis. Cochrane Database Syst. Rev. 2020, 2020, CD009880. [Google Scholar] [CrossRef] [Green Version]
- Paz, D.L.; Lakbar, I.; Tattevin, P. A review of current treatment strategies for infective endocarditis. Expert Rev. Anti-Infective Ther. 2020, 19, 297–307. [Google Scholar] [CrossRef]
- Murdoch, D.R.; Corey, G.R.; Hoen, B.; Miro, J.M.; Fowler, V.G., Jr.; Bayer, A.S.; Karchmer, A.W.; Olaison, L.; Pappas, P.A.; Moreillon, P.; et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: The International Collaboration on Endocarditis-Prospective Cohort Study. Arch. Intern. Med. 2009, 169, 463–473. [Google Scholar] [CrossRef] [Green Version]
- Fowler, V.G.; Miro, J.M.; Hoen, B.; Cabell, C.H.; Abrutyn, E.; Rubinstein, E.; Corey, G.R.; Spelman, D.; Bradley, S.F.; Barsic, B.; et al. Staphylococcus aureus Endocarditis. JAMA 2005, 293, 3012–3021. [Google Scholar] [CrossRef] [Green Version]
- Diemberger, I.; Biffi, M.; Lorenzetti, S.; Martignani, C.; Raffaelli, E.; Ziacchi, M.; Rapezzi, C.; Pacini, D.; Boriani, G. Predictors of long-term survival free from relapses after extraction of infected CIED. Europace 2017, 20, 1018–1027. [Google Scholar] [CrossRef]
- Luciani, N.; Mossuto, E.; Ricci, D.; Luciani, M.; Russo, M.; Salsano, A.; Pozzoli, A.; Pierri, M.D.; D’Onofrio, A.; Chiariello, G.A.; et al. Prosthetic valve endocarditis: Predictors of early outcome of surgical therapy. A multicentric study. Eur. J. Cardio-Thorac. Surg. 2017, 52, 768–774. [Google Scholar] [CrossRef] [PubMed]
- Lin, Y.; Dong, S.; Yuan, J.; Yu, D.; Bei, W.; Chen, R.; Qin, H. Accuracy and Prognosis Value of the Sequential Organ Failure Assessment Score Combined With C-Reactive Protein in Patients With Complicated Infective Endocarditis. Front. Med. 2021, 8. [Google Scholar] [CrossRef] [PubMed]
- Alves, S.G.; Júnior, F.P.; Filippini, F.B.; Dannenhauer, G.P.; Miglioranza, M.H. SHARPEN score accurately predicts in-hospital mortality in infective endocarditis. Eur. J. Intern. Med. 2021, 92, 124–127. [Google Scholar] [CrossRef] [PubMed]
- Marques, A.; Cruz, I.; Caldeira, D.; Alegria, S.; Gomes, A.C.; Broa, A.L.; João, I.; Pereira, H. Fatores de Risco para Mortalidade Hospitalar na Endocardite Infecciosa. Arq. Bras. Cardiol. 2019, 114, 1–8. [Google Scholar] [CrossRef] [PubMed]
- Motoc, A.; Kessels, J.; Roosens, B.; Lacor, P.; Van de Veire, N.; De Sutter, J.; Magne, J.; Droogmans, S.; Cosyns, B. Impact of the initial clinical presentation on the outcome of patients with infective endocarditis. Cardiol. J. 2021. [Google Scholar] [CrossRef]
- Iung, B.; Erba, P.A.; Petrosillo, N.; Lazzeri, E. Common diagnostic flowcharts in infective endocarditis. Q. J. Nucl. Med. Mol. Imaging 2014, 58, 55–65. [Google Scholar]
- Durante-Mangoni, E.; Giuffrè, G.; Ursi, M.P.; Iossa, D.; Bertolino, L.; Senese, A.; Pafundi, P.C.; D’Amico, F.; Albisinni, R.; Zampino, R. Predictors of long-term mortality in left-sided infective endocarditis: An historical cohort study in 414 patients. Eur. J. Intern. Med. 2021, 94, 27–33. [Google Scholar] [CrossRef]
- Fernández-Hidalgo, N.; Almirante, B.; Tornos, P.; González-Alujas, M.; Planes, A.; Larrosa, M.N.; Sambola, A.; Igual, A.; Pahissa, A. Prognosis of left-sided infective endocarditis in patients transferred to a tertiary-care hospital—prospective analysis of referral bias and influence of inadequate antimicrobial treatment. Clin. Microbiol. Infect. 2011, 17, 769–775. [Google Scholar] [CrossRef] [Green Version]
- Buburuz, A.-M.; Petris, A.; Costache, I.; Jelihovschi, I.; Arsenescu-Georgescu, C.; Iancu, L. Evaluation of Laboratory Predictors for In-Hospital Mortality in Infective Endocarditis and Negative Blood Culture Pattern Characteristics. Pathogens 2021, 10, 551. [Google Scholar] [CrossRef]
- Li, Z.; Gao, Q.; Ren, Z.; Zhou, H.; Qian, Z.; Peng, J. Nomogram based on neutrophil-to-platelet ratio to predict in-hospital mortality in infective endocarditis. Biomarkers Med. 2021, 15, 1233–1243. [Google Scholar] [CrossRef]
- Arregle, F.; Martel, H.; Philip, M.; Gouriet, F.; Casalta, J.P.; Riberi, A.; Torras, O.; Casalta, A.-C.; Camoin-Jau, L.; Lavagna, F.; et al. Infective endocarditis with neurological complications: Delaying cardiac surgery is associated with worse outcome. Arch. Cardiovasc. Dis. 2021, 114, 527–536. [Google Scholar] [CrossRef] [PubMed]
- Neurological Sequelae of Endocarditis–PubMed. Available online: https://pubmed.ncbi.nlm.nih.gov/31194361/ (accessed on 22 September 2021).
- Alegria, S.; Marques, A.; Cruz, I.; Broa, A.L.; Pereira, A.R.F.; João, I.; Simões, O.; Pereira, H. Complicações Neurológicas em Pacientes com Endocardite Infecciosa: Perspectivas de um Centro Terciário. Arq. Bras. De Cardiol. 2021, 116, 682–691. [Google Scholar] [CrossRef] [PubMed]
- Chakraborty, T.; Rabinstein, A.; Wijdicks, E. Neurologic complications of infective endocarditis. Neurol. Clin. 2021, 177, 125–134. [Google Scholar] [CrossRef]
- Netzer, R.O.M.; Zollinger, E.; Seiler, C.; Cerny, A. Infective endocarditis: Clinical spectrum, presentation and outcome. An analysis of 212 cases 1980–1995. Heart 2000, 84, 25–30. [Google Scholar] [CrossRef] [Green Version]
- Bui, J.T.; Schranz, A.J.; Strassle, P.D.; Agala, C.B.; Mody, G.N.; Ikonomidis, J.S.; Long, J.M. Pulmonary complications observed in patients with infective endocarditis with and without injection drug use: An analysis of the National Inpatient Sample. PLoS ONE 2021, 16, e0256757. [Google Scholar] [CrossRef]
- Yu, C.-W.; Juan, L.-I.; Hsu, S.-C.; Chen, C.-K.; Wu, C.-W.; Lee, C.-C.; Wu, J.-Y. Role of procalcitonin in the diagnosis of infective endocarditis: A meta-analysis. Am. J. Emerg. Med. 2013, 31, 935–941. [Google Scholar] [CrossRef]
- Primus, C.P.; A Clay, T.; McCue, M.S.; Wong, K.; Uppal, R.; Ambekar, S.; Das, S.; Bhattacharyya, S.; Davies, L.C.; Woldman, S.; et al. 18F-FDG PET/CT improves diagnostic certainty in native and prosthetic valve Infective Endocarditis over the modified Duke Criteria. J. Nucl. Cardiol. 2021, 1–10. [Google Scholar] [CrossRef]
- Hoen, B.; Selton-Suty, C.; Lacassin, F.; Etienne, J.; Briançon, S.; Leport, C.; Canton, P. Infective Endocarditis in Patients with Negative Blood Cultures: Analysis of 88 Cases from a One-Year Nationwide Survey in France. Clin. Infect. Dis. 1995, 20, 501–506. [Google Scholar] [CrossRef]
Age, Year | 65.6 ± 17.4 |
---|---|
Sex: | |
M | 46 (67.6%) |
F | 22 (32.4%) |
Drug addiction | 10 (14.7%) |
Duration of hospitalization, d | 23.9 ± 15 |
Heart Valve: | |
• Native valve; | 44 (64.7%) |
• Mechanical valve; | 24 (35.3%) |
• Early onset; | 3 (12.5%) |
• Late onset. | 21 (87.5%) |
Comorbidities: | |
• Diabetes mellitus; | 23 (33.8%) |
• Hypertension; | 42 (61.8%) |
• Heart failure; | 7 (10.3%) |
• Ischemic heart disease; | 11 (16.2%) |
• Chronic renal failure; | 11 (16.2%) |
• Immunosuppression. | 4 (5.9%) |
Hb, g/dL | 11.10 ± 2.04 |
WBC, cell/mm3 | 12,390 ± 6430 |
PLT, cell/mm3 | 205,560 ± 110,800 |
INR | 1.34 ± 0.49 |
ERS, mm/h | 40.6 ± 35.21 |
PCR, mg/dL | 12.2 ± 14.85 |
PCT, ng/mL | |
- Basal | 7.43 ± 20.27 |
- 48–72 h | 3.59 ± 13.10 |
48–72 h | |
eGFR, mL/min/1.73 m2 | 76.7 ± 38.2 |
Troponin, U/L | 0.74 ± 2.60 |
LDH, U/L | 630 ± 470 |
NT-Pro-BNP, pg/mL | 3653.3 ± 848 |
Ejection fraction, % | 59.4 ± 8.01 |
Clinical Manifestation | N (%) |
---|---|
Fever (with or without chills) | 50 (73.6) |
Cutaneous manifestations | 14 (20.6) |
Focal neurologic deficits | 7 (10.3) |
Asthenia and non-specific symptoms | 17 (25.1) |
New-onset heart murmur | 42 (61.8) |
Embolization | N (%) |
---|---|
Splenic | 7 (10.3) |
Pulmonary | 8 (11.7) |
Mixed (splenic ± renal, ± lower limbs, ± mesenteric) | 5 (7.3) |
Cerebral embolization | 7 (10.3) |
Total embolic events | 27 (39.6) |
Pearson R | p-Value | |||||
---|---|---|---|---|---|---|
Discharge | 30 Days | 6 Months | Discharge | 30 Days | 6 Months | |
Age | 0.346 | 0.386 | 0.386 | 0.004 | 0.001 | 0.001 |
eGFR | −0.343 | −0.437 | −0.425 | 0.004 | <0.001 | <0.001 |
Basal PCT | 0.266 | 0.337 | 0.339 | 0.029 | 0.005 | 0.005 |
48–72 h PCT | 0.222 | 0.308 | 0.305 | 0.049 | 0.011 | 0.011 |
New-onset heart murmur | 0.311 | 0.273 | 0.294 | 0.010 | 0.025 | 0.015 |
Non-continued antibiotic therapy | 0.232 | 0.239 | 0.283 | 0.050 | 0.05 | 0.019 |
Neurological manifestations | - | - | 0.284 | - | - | 0.019 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Ucciferri, C.; Auricchio, A.; Cutone, C.; Di Gasbarro, A.; Vecchiet, J.; Falasca, K. Risk Factors Associated with Poor Outcome in Patients with Infective Endocarditis: An Italian Single-Center Experience. Infect. Dis. Rep. 2022, 14, 213-219. https://doi.org/10.3390/idr14020026
Ucciferri C, Auricchio A, Cutone C, Di Gasbarro A, Vecchiet J, Falasca K. Risk Factors Associated with Poor Outcome in Patients with Infective Endocarditis: An Italian Single-Center Experience. Infectious Disease Reports. 2022; 14(2):213-219. https://doi.org/10.3390/idr14020026
Chicago/Turabian StyleUcciferri, Claudio, Antonio Auricchio, Carmine Cutone, Alessandro Di Gasbarro, Jacopo Vecchiet, and Katia Falasca. 2022. "Risk Factors Associated with Poor Outcome in Patients with Infective Endocarditis: An Italian Single-Center Experience" Infectious Disease Reports 14, no. 2: 213-219. https://doi.org/10.3390/idr14020026
APA StyleUcciferri, C., Auricchio, A., Cutone, C., Di Gasbarro, A., Vecchiet, J., & Falasca, K. (2022). Risk Factors Associated with Poor Outcome in Patients with Infective Endocarditis: An Italian Single-Center Experience. Infectious Disease Reports, 14(2), 213-219. https://doi.org/10.3390/idr14020026