Cumulative incidence and mortality of infective endocarditis in Siriraj hospital-Thailand: a 10-year retrospective study

• Published in: BMC infectious diseases 2019-12, Vol.19 (1), p.1062-1062, Article 1062
• Main Authors: Angsutararux, Taksaon, Angkasekwinai, Nasikarn
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antibiotics; Cardiovascular disease; Chronic kidney failure; Comorbidity; Complications; Complications and side effects; Confidence intervals; Congestive heart failure; Cross Infection; Development and progression; Diabetes mellitus; End-stage renal disease; Endocarditis; Endocarditis, Bacterial - epidemiology; Endocarditis, Bacterial - microbiology; Endocarditis, Bacterial - mortality; Enterococcus - isolation & purification; Epidemiology; Female; Heart; Heart failure; Hemodialysis; Hospital Mortality; Hospitals; Humans; Incidence; Infectious diseases; Infective endocarditis; Kidney diseases; Male; Medical equipment; Methicillin; Middle Aged; Mortality; Native valve IE; Pathogenic microorganisms; Pathogens; Patients; Prostheses; Prostheses and implants; Prosthetic valve IE; Retrospective Studies; Rheumatic heart disease; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcal Infections - mortality; Staphylococcus aureus; Staphylococcus aureus - isolation & purification; Staphylococcus aureus infections; Streptococcal Infections - epidemiology; Streptococcal Infections - microbiology; Streptococcal Infections - mortality; Streptococcus - isolation & purification; Studies; Thailand; Thailand - epidemiology; Variables; Viridans Streptococci - isolation & purification; Young Adult
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-019-4689-5

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. Medical charts of adult patients diagnosed with IE by Duke criteria at Siriraj Hospital during January 2005 to May 2015 were retrospectively reviewed. 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. 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.