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 Detalle_Publicacion

Infective endocarditis: Absence of microbiological diagnosis is an independent predictor of inhospital mortality

Abstract: Background: Infective endocarditis (IE) is associated with high inhospital mortality. New microbiological diagnostic techniques have reduced the proportion of patients without etiological diagnosis, but in a significant number of patients the cause is still unknown. Our aimwas to study the association of the absence of microbiological diagnosis with in-hospital prognosis. Methods: Prospective cohort of 2000 consecutive patients with IE. Data were collected in 26 Spanish hospitals. Modified Duke criteria were used to diagnose patients with suspected IE. Results: A total of 290 patients (14.8%) had negative blood cultures. Etiological diagnosis was achievedwith other methods (polymerase chain reaction, serology and other cultures) in 121 (6.1%). Finally, therewere 175 patients (8.8%)without microbiological diagnosis (Group A) and 1825with diagnosis (Group B). In-hospital mortality occurred in 58 patients inGroup A (33.1%) vs. 487 (26.7%) inGroup B, p=0.07. Patients inGroup A had a lower risk profile than those in Group B,with less comorbidity (Charlson index 1.9±2.0 vs. 2.3±2.1, p=0.03) and lower surgical risk (EuroSCORE 23.6±21.8 vs. 29.6±25.2, p=0.02). However they presented heart failure more frequently (53% vs. 40%, p=0.005).Multivariate analysis showed that the absence of microbiological diagnosis was an independent predictor of inhospital mortality (odds ratio 1.8, 95% Confidence Interval 1.1?2.9, p = 0.016). Conclusion: Approximately 9% of patients with IE had no microbiological diagnosis. Absence of microbiological diagnosis was an independent predictor of inhospital mortality.

 Fuente: International Journal of Cardiology 220 (2016) 162-165

Editorial: Elsevier

 Año de publicación: 2016

Nº de páginas: 4

Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.ijcard.2016.06.129

ISSN: 0167-5273,1874-1754

Autores/as

DÍEZ VILLANUEVA, PABLO

MUÑOZ, PATRICIA

MARÍN, MERCEDES

BERMEJO, JAVIER

ALARCÓN GONZÁLEZ, ARÍSTIDES DE

MANUEL GUTIERREZ CUADRA

PERICÁS PULIDO, JOSE MANUEL

LEPE, JOSÉ ANTONIO

CASTELO, LAURA

GOENAGA, MIGUEL ÁNGEL

RUIZ MORALES, JOSEFA

TARABINI, PAOLA

MARTÍNEZ SELLÉS, MANUEL

GAMES