Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey

KURTOĞLU, Hilal; ŞENER, Murat; Kose, Ozkan; YILDIRIMTÜRK, Özlem; Aytekin, Saide; baytaroglu, corç; TUĞCU, Aylin

Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey

Aylin TUĞCU, (Florence Nightingale Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye)

Özlem YILDIRIMTÜRK, (Florence Nightingale Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye)

Corç BAYTAROĞLU, (Florence Nightingale Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye)

Hilal KURTOĞLU, (İstnabul Bilim Üniversitesi, Florence Nightingale Hastanesi, Kardiyoloji Anabilim Dalı, İstanbul, Türkiye)

Özkan KÖSE, (İstnabul Bilim Üniversitesi, Florence Nightingale Hastanesi, Kardiyoloji Anabilim Dalı, İstanbul, Türkiye)

Murat ŞENER, (İstnabul Bilim Üniversitesi, Florence Nightingale Hastanesi, Kardiyoloji Anabilim Dalı, İstanbul, Türkiye)

Saide AYTEKİN (İstnabul Bilim Üniversitesi, Florence Nightingale Hastanesi, Kardiyoloji Anabilim Dalı, İstanbul, Türkiye)

Türk Kardiyoloji Derneği Arşivi

4 1

Yıl: 2009 Cilt: 37 Sayı: 1 Sayfa Aralığı: 9 - 18 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey

Öz:

Amaç: Çalışmada, üçüncü basamak bir hastanede infektif endokarditli (İE) olguların klinik, laboratuvar, mikrobiyolojik ve ekokardiyografik özelliklerinin incelemesi ve hastane içi mortaliteyi etkileyen etkenlerin belirlenmesi amaçlandı. Ça lış ma pla nı: 1997 ve 2007 yılları arasında hastanemizde modifiye Duke ölçütlerine göre kesin veya olası İE tanısı konan 68 hastanın (40 erkek, 28 kadın; ort. yaş 51±20) klinik kayıtları ve tedavi sonuçları geriye dönük olarak incelendi. Bul gu lar: Yirmi sekiz hastada (%41.2) nativ kapak endokarditi (NKE), 38 hastada (%55.9) protez kapak endokarditi (PKE) saptandı. Pacemaker endokarditi (PE) sadece iki olguda (%2.9) görüldü. On dokuz hastada (%27.9) hastane içi İE vardı. Romatizmal kalp hastalığı NKE açısından başta gelen risk faktörü idi (n=11; %39.3). Ekokardiyografide, PKE'li beş hastada (%13.2) tutulum bulgusuna rastlanmadı. Stafilokoklar NKE, PKE ve PE’ye neden olan en sık mikroorganizma idi (n=28; %41.2). Kırk altı hastada (%67.7) en az bir komplikasyon gelişti; bunlar içinde en sık komplikasyon konjestif kalp yetersizliği (n=38; %55.9) idi. Kırk bir hastada (%60.3) birleşik (tıbbi ve cerrahi) tedavi uygulandı. Hastane içi ölüm 17 hastada (%25) görüldü. Mortalite oranları erken ve geç PKE'de ve NKE'de sırasıyla %37.5, %30 ve %14.3 idi. Ayrıca, hastane içi İE grubundaki mortalite (%57.9), diğer olgulara göre anlamlı derecede yüksek bulundu. Çokdeğişkenli analizde, septik şok (p=0.011) ve hastane içi infeksiyon (p=0.032), hastane içi mortaliteyi etkileyen bağımsız faktörler olarak bulundu. So nuç: Avrupa'daki serilerle karşılaştırıldığında, hasta grubumuzda İE daha erken yaşta gözlendi ve altta yatan en sık faktör romatizmal kalp hastalığı idi. Protez kapak endokarditi, hastane içi İE ve cerrahi tedavi oranlarımız benzer bulundu

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Üçüncü basamak bir hastanede infektif endokarditli 68 olguda klinik spektrum, başvuru şekilleri ve mortalite açısından risk faktörlerinin değerlendirilmesi

Öz:

Objectives: This study was designed to evaluate clinical, laboratory, microbiological, and echocardiographic characteristics of infective endocarditis (IE) at a tertiary care center in Turkey and to identify predictors of in-hospital mortality. Study design: Based on a systematic retrospective review of clinical records covering 1997 to 2007, we analyzed data and outcomes of 68 patients (40 males, 28 females; mean age 51±20 years) with definite or possible IE according to the modified Duke criteria. Results: Native valve endocarditis (NVE) was seen in 28 patients (41.2%), and prosthetic valve endocarditis (PVE) was seen in 38 patients (55.9%). Pacemaker endocarditis (PE) was observed in only two patients (2.9%). Nineteen patients (27.9%) had nosocomial IE. The most frequent predisposing factor for NVE was rheumatic heart disease (n=11; 39.3%). Echocardiography failed to show any signs of involvement in five patients (13.2%) with PVE. The most common causative microorganisms of NVE, PVE, and PE were staphylococci (n=28; 41.2%). At least one complication developed in 46 patients (67.7%), congestive heart failure being the most common (n=38; 55.9%). Forty-one patients (60.3%) underwent combined medical and surgical treatment. In-hospital mortality occurred in 17 patients (25%). Mortality rates were 37.5%, 30%, and 14.3% for early and late PVE and NVE, respectively. Mortality was significantly higher with nosocomial IE (57.9%) compared to 12.2% in the remaining patients. In multivariate analysis, septic shock (p=0.011) and nosocomial infection (p=0.032) were independently associated with in-hospital mortality. Conclusion: Compared to the European series, IE in our cohort occurred in a relatively younger population, with rheumatic heart disease as the most common underlying heart disease. The rates of PVE, nosocomial IE, and surgical treatment were about the same.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	TUĞCU A, YILDIRIMTÜRK Ö, baytaroglu c, KURTOĞLU H, Kose O, ŞENER M, Aytekin S (2009). Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey. , 9 - 18.
Chicago	TUĞCU Aylin,YILDIRIMTÜRK Özlem,baytaroglu corç,KURTOĞLU Hilal,Kose Ozkan,ŞENER Murat,Aytekin Saide Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey. (2009): 9 - 18.
MLA	TUĞCU Aylin,YILDIRIMTÜRK Özlem,baytaroglu corç,KURTOĞLU Hilal,Kose Ozkan,ŞENER Murat,Aytekin Saide Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey. , 2009, ss.9 - 18.
AMA	TUĞCU A,YILDIRIMTÜRK Ö,baytaroglu c,KURTOĞLU H,Kose O,ŞENER M,Aytekin S Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey. . 2009; 9 - 18.
Vancouver	TUĞCU A,YILDIRIMTÜRK Ö,baytaroglu c,KURTOĞLU H,Kose O,ŞENER M,Aytekin S Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey. . 2009; 9 - 18.
IEEE	TUĞCU A,YILDIRIMTÜRK Ö,baytaroglu c,KURTOĞLU H,Kose O,ŞENER M,Aytekin S "Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey." , ss.9 - 18, 2009.
ISNAD	TUĞCU, Aylin vd. "Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey". (2009), 9-18.

APA	TUĞCU A, YILDIRIMTÜRK Ö, baytaroglu c, KURTOĞLU H, Kose O, ŞENER M, Aytekin S (2009). Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey. Türk Kardiyoloji Derneği Arşivi, 37(1), 9 - 18.
Chicago	TUĞCU Aylin,YILDIRIMTÜRK Özlem,baytaroglu corç,KURTOĞLU Hilal,Kose Ozkan,ŞENER Murat,Aytekin Saide Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey. Türk Kardiyoloji Derneği Arşivi 37, no.1 (2009): 9 - 18.
MLA	TUĞCU Aylin,YILDIRIMTÜRK Özlem,baytaroglu corç,KURTOĞLU Hilal,Kose Ozkan,ŞENER Murat,Aytekin Saide Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey. Türk Kardiyoloji Derneği Arşivi, vol.37, no.1, 2009, ss.9 - 18.
AMA	TUĞCU A,YILDIRIMTÜRK Ö,baytaroglu c,KURTOĞLU H,Kose O,ŞENER M,Aytekin S Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey. Türk Kardiyoloji Derneği Arşivi. 2009; 37(1): 9 - 18.
Vancouver	TUĞCU A,YILDIRIMTÜRK Ö,baytaroglu c,KURTOĞLU H,Kose O,ŞENER M,Aytekin S Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey. Türk Kardiyoloji Derneği Arşivi. 2009; 37(1): 9 - 18.
IEEE	TUĞCU A,YILDIRIMTÜRK Ö,baytaroglu c,KURTOĞLU H,Kose O,ŞENER M,Aytekin S "Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey." Türk Kardiyoloji Derneği Arşivi, 37, ss.9 - 18, 2009.
ISNAD	TUĞCU, Aylin vd. "Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: A review of 68 cases at a tertiary care center in Turkey". Türk Kardiyoloji Derneği Arşivi 37/1 (2009), 9-18.