An Audit of Infective Endocarditis Admissions at a Single Centre Over a 5-Year Period.

Abstract

Introduction: Infective endocarditis (IE) is defined by infection of the endocardium, native or prosthetic valves, and indwelling cardiac devices. Despite advances in diagnosis and treatment, IE in-hospital mortality remains high and is quoted to be 10-30% [1]. This clinical retrospective audit examines the epidemiology and outcomes of patients admitted with IE to an Australian centre between 2016-2021. Method(s): Patients admitted with the diagnosis 'infective endocarditis' were searched from electronic medical records. Epidemiology and outcome data were collected for those with 'definite' or 'possible' IE according to Modified Duke criteria. Result(s): 164 patients were included; 93 (56.7%) had 'definite' IE. Median age was 64, and 109 (66.5%) were male. Risk factors included: prior IE (n=8, 4.9%), prosthetic valve (n=22, 13.4%), haemodialysis (n=9, 5.5%), native valve disease (n=9, 5.5%), cardiac device (n=7, 4.3%), congenital heart disease (n=7, 4.3%), and intravenous drug use (n=34, 20.7%). Complications included new valvular dysfunction (n=17, 10.4%), aortic root abscesses (n=4, 2.4%), heart failure (n=9, 5.5%), and mycotic aneurysms (n=2, 1.2%). Within the study period, 41 patients (25%) were transferred, 23 (14.0%) required cardiothoracic surgery and 22 (13.4%) died. Conclusion(s): Although the incidence of IE is low, life-threatening haemodynamic compromise can occur when IE is complicated by acute surgical pathology. Our audit demonstrates that a significant group of patients required transfer to a cardiac surgical centre for intervention. This illustrates how patients with IE require close monitoring as well as early discussions with multidisciplinary teams to improve overall outcomes. References: [1] Chu VH et al. Early predictors of in-hospital death in infective endocarditis. Circulation. 2004 Apr 13;109(14):1745-9.Copyright � 2024