Infective Endocarditis in a Regional Hospital – 10-year Analysis in Izola General Hospital
Abstract
Introduction: Infective endocarditis (IE) is a serious disease with a high mortality rate and is defned as an inflammation of the endocardium, caused by microorganisms. Most data about IE originate from referral hospitals, therefore we aimed to analyse the demographics, presentation, diagnostics, treatment and outcome of IE at a regional hospital (Izola General Hospital–SBI) in a 10-year period.
Methods: We analysed 51 episodes of IE and compared patients who were treated at a regional hospital alone, to those transferred to a referral centre. We also included data about all IE patients in a large referral hospital (University Medical Centre Ljubljana–UMCL).
Results: Gender and age of the patients in SBI were similar to UMCL patients, however, there was a slightly higher share of IE in drug users and lower of prosthetic valve endocarditis. Our patients more often had streptococcal and less often staphylococcal endocarditis. Fewer patients needed surgery and time to operation was 17 days (median). Twenty-six percent of the patients died in the hospital. Approximately a half of the patients were transferred to a referral hospital, more often younger patients and women. The transferred patients often underwent surgery.
Conclusions: Good cooperation with a referral hospital ensures that the outcome and other data of IE patients treated at a regional hospital are comparable to those in the literature. Some differences between patients treated in the regional hospital and the referral centre were observed. Time from admission to surgery could be shortened.
Downloads
References
Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta J-P, Del Zotti F, et al. 2015 ESC Guidelines for the management of infective endocarditis. European heart journal. 2015;36(44):3075–128.
Lejko-Zupanc T. Zgodnja in pozna prognoza infekcijskega endokarditisa [doktorsko delo]. Ljbuljana: T. Lejko Zupanc; 1999.
Leone S, Ravasio V, Durante-Mangoni E, Crapis M, Carosi G, Scotton PG, et al. Epidemiology, characteristics, and outcome of infective endocarditis in Italy: the Italian Study on Endocarditis. Infection. 2012;40(5):527–35.
Dzupova O, Machala L, Baloun R, Maly M, Benes J. Incidence, predisposing factors, and aetiology of infective endocarditis in the Czech Republic. Scandinavian Journal of Infectious Diseases. 2011;44(4):250–5.
DeSimone DC, Tleyjeh IM, Correa de Sa DD, Anavekar NS, Lahr BD, Sohail MR, et al. Temporal trends in infective endocarditis epidemiology from 2007 to 2013 in Olmsted County, MN. American heart journal. 2015;170(4):830–6.
Sy RW, Kritharides L. Health care exposure and age in infective endocarditis: results of a contemporary population-based profle of 1536 patients in Australia. European heart journal. 2010;31(15):1890–7.
Murdoch DR. Clinical Presentation, Etiology, and Outcome of Infective Endocarditis in the 21st Century. Archives of internal medicine. 2009;169(5):463.
Tornos P. Infective endocarditis in Europe: lessons from the Euro heart survey. Heart (British Cardiac Society). 2005;91(5):571–5.
Fernández-Hidalgo N, Tornos Mas P. Epidemiology of Infective Endocarditis in Spain in the Last 20 Years. Revista Española de Cardiología (English Edition). 2013;66(9):728–33.
Hill EE, Herijgers P, Herregods MC, Peetermans WE. Evolving trends in infective endocarditis. Clinical Microbiology and Infection. 2006;12(1):5–12.
Dayer MJ, Jones S, Prendergast B, Baddour LM, Lockhart PB, Tornhill MH. Incidence of infective endocarditis in England, 2000–13: a secular trend, interrupted time-series analysis. Te Lancet. 2015;385(9974):1219–28.
Krek M. Delež uporabnikov programa Centra za preprečevanje in zdravljenje odvisnosti Koper v med uporabniki programa v Sloveniji v letih 2008–2014. Neobjavljeno. 2016.
Poesen K, Pottel H, Colaert J, Niel CD. Epidemiology of infective endocarditis in a large Belgian non-referral hospital. Acta clinica Belgica. 2014;69(3):183–90.
Hase R, Otsuka Y, Yoshida K, Hosokawa N. Profle of infective endocarditis at a tertiary-care hospital in Japan over a 14-year period: characteristics, outcome and predictors for in-hospital mortality. International Journal of Infectious Diseases. 2015;33:62–6.
Cecchi E, Chirillo F, Castiglione A, Faggiano P, Cecconi M, Moreo A, et al. Clinical epidemiology in Italian Registry of Infective Endocarditis (RIEI): Focus on age, intravascular devices and enterococci. International journal of cardiology. 2015;190:151–6.
Hoen B, Alla F, Selton-Suty C. Changing profile of infective endocarditis: results of a 1-year survey in France. ACC Current Journal Review. 2002;11(6):18–9.
Walls G, McBride S, Raymond N, Read K, Coomarasamy C, Morris AJ, et al. Infective endocarditis in New Zealand: data from the International Collaboration on Endocarditis Prospective Cohort Study. N Z Med J. 2014;127(1391):38–51.
Chu VH, Park LP, Athan E, Delahaye F, Freiberger T, Lamas C, et al. Association Between Surgical Indications, Operative Risk, and Clinical Outcome in Infective Endocarditis: A Prospective Study From the International Collaboration on Endocarditis. Circulation. 2014;131(2):131–40.
Kang D-H, Kim Y-J, Kim S-H, Sun BJ, Kim D-H, Yun S-C, et al. Early Surgery versus Conventional Treatment for Infective Endocarditis. New England Journal of Medicine. 2012;366(26):2466–73.
Alagna L, Park LP, Nicholson BP, Keiger AJ, Strahilevitz J, Morris A, et al. Repeat endocarditis: analysis of risk factors based on the International Collaboration on Endocarditis – Prospective Cohort Study. Clinical Microbiology and Infection. 2014;20(6):566–75.
Kanafani ZA, Kanj SS, Cabell CH, Cecchi E, Oliveira Ramos A, Lejko-Zupanc T, et al. Revisiting the effect of referral bias on the clinical spectrum of infective endocarditis in adults. European Journal of Clinical Microbiology & Infectious Diseases. 2010;29(10):1203-10.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
