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Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases 12/2008

01.12.2008 | Article

Clinical and echocardiographic risk factors for embolism and mortality in infective endocarditis

verfasst von: Evelyn E. Hill, Paul Herijgers, Piet Claus, Steven Vanderschueren, Willy E. Peetermans, Marie-Christine Herregods

Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases | Ausgabe 12/2008

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Abstract

Data about predictors of embolism in patients with infective endocarditis (IE) are conflicting. This study aimed to investigate clinical and transoesophageal echocardiography (TEE) characteristics in predicting embolism and six-month mortality. In this observational cohort study, 216 patients with definite left-sided IE, according to the modified Duke criteria, were prospectively recruited. All patients underwent TEE. ‘Any embolism’ was defined as embolism before or after initiation of antimicrobial therapy; ‘new embolism’ included embolism after initiation of antimicrobial therapy. Sixty-two of 216 patients (29%) experienced any embolism. New embolism occurred in 12 patients (6%), 7 of which were postoperative. Factors significantly associated with any embolism were community origin of IE and the etiologic microorganism, in particular staphylococci and nonviridans streptococci. Vegetation length >10 mm showed a trend towards association with new embolism and a mobile vegetation was predictive for new embolism. Six-month mortality was 24% (52/216). In multivariable analysis, age, vegetation length >10 mm, Staphylococcus aureus, and the type of treatment predicted mortality. Multiple emboli showed a trend towards association with death. In conclusion, any embolism occurred in over a fourth of patients. A mobile vegetation was significantly associated with new embolism, and vegetation length >10 mm tended to be associated with new embolism. Vegetation length >10 mm predicted six-month mortality, and multiple emboli showed a trend towards association with death.
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Metadaten
Titel
Clinical and echocardiographic risk factors for embolism and mortality in infective endocarditis
verfasst von
Evelyn E. Hill
Paul Herijgers
Piet Claus
Steven Vanderschueren
Willy E. Peetermans
Marie-Christine Herregods
Publikationsdatum
01.12.2008
Verlag
Springer-Verlag
Erschienen in
European Journal of Clinical Microbiology & Infectious Diseases / Ausgabe 12/2008
Print ISSN: 0934-9723
Elektronische ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-008-0572-9

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