1Klinikum der Stadt Ludwigshafen gGmbH Medizinische Klinik B Ludwigshafen am Rhein, Deutschland; 2Stiftung Institut für Herzinfarktforschung Ludwigshafen am Rhein, Deutschland; 3IHF GmbH Ludwigshafen am Rhein, Deutschland; 4Klinikum der Stadt Ludwigshafen gGmbH Ludwigshafen am Rhein, Deutschland
Background: Infective endocarditis (IE) is still a serious disease, with a high hospital and long-term mortality. However, data on differences between native valve (NV) IE, prosthetic valve (PV) IE and cardiovascular implanted electronic device (CIED) related IE are sparse.
Methods: Retrospective single centre registry on the hospital course and long-term follow-up of patients with IE.
Results: Between 1/2013 and 12/2016, 171 IE patients were treated at our hospital. A follow-up with either patient contact, review of hospital charts or physician contact was performed in 2022. Due to lost to follow-up (n=4) and refusal to participate after discharge (n=1), the final evaluation was performed with 166 patients (97,1%). They were followed-up for a median 2385,0 (between 2156,0 and 2773,0) days.
|
|
NV-IE n=85 |
PV-IE n=53 |
CIED-IE n=33
|
p-value |
|
Age (years) |
63±14 |
70±13 |
70±13 |
0,01 |
|
Women |
28,2% |
20,8% |
24,2% |
ns |
|
renal failure |
21,2% |
41,5% |
48,5% |
0,005 |
|
Positive blood cultures |
78,8% |
88,7% |
69,7% |
ns |
|
Gram positive strains |
97% |
100% |
96% |
ns |
|
In-hospital cardiac surgery |
87,1% |
67,9% |
87,9% |
0,01 |
|
Hospital mortality |
23,5% |
20,8% |
18,2% |
ns |
|
Follow-up (after median 2385 days) |
|
|
|
|
|
Calculated 1 year mortality |
27,7% |
32,0% |
21,2% |
ns |
|
Calculated 3 year mortality |
43,4% |
44,0% |
42,4% |
ns |
|
Calculated 5 year mortality |
53,0% |
58,0% |
48,5% |
ns |
|
Endocarditis related mortality |
|
|
|
|
|
Probable/certain |
66,7% |
62,9% |
81,0% |
|
|
Uncertain |
11,8% |
20,0% |
4,8% |
|
|
Not related |
21,6% |
17,1% |
14,3% |
|
|
Re-hospitalisation for recurrent IE |
75,0% |
76,0% |
80,0% |
ns |
Conclusions: These data on long-term follow-up after IE show only little differences between NV-IE, PV-IE and CIED-IE, with NV-IE patients being younger and having less co-morbidities. Cardiac surgery was less often performed in PV-IE. However, long-term mortality is similar in all groups, with more than 2/3 of deaths were due to IE. Furthermore, rehospitalisation rates for recurrent IE were also high.