Profile of infective endocarditis at a tertiary-care hospital in Japan over a 14-year period: characteristics, outcome and predictors for in-hospital mortality

Int J Infect Dis. 2015 Apr;33:62-6. doi: 10.1016/j.ijid.2015.01.003. Epub 2015 Jan 7.

Abstract

Objectives: The aims of this study were to describe the epidemiological features and clinical characteristics of infective endocarditis (IE) at a tertiary-care hospital in Japan and to identify the factors associated with in-hospital mortality.

Methods: A retrospective observational study was conducted at a 925-bed tertiary-care teaching hospital in Japan. All adult patients diagnosed with definite IE between August 2000 and July 2014 according to the modified Duke criteria were included.

Results: A total of 180 patients (60.6% men; mean age, 69.1 years) with definite IE were included. The most common pathogen was Staphylococcus aureus (27.2%). Nine patients (5.0%) had culture-negative IE. Transthoracic and transoesophageal echocardiography were performed in 180 (100%) and 132 patients (73.3%), respectively, and vegetations were detected in 128 patients (71.1%). Surgical therapy was performed in 31 patients (17.2%). Overall, the in-hospital mortality rate was 26.1%. The independent predictors of in-hospital mortality were methicillin-resistant S. aureus (MRSA), vascular phenomena, health care-associated IE and heart failure.

Conclusions: MRSA, vascular phenomena, health care-associated IE and heart failure were independent predictors of in-hospital mortality. The unique characteristics in our cohort were the very high mean age, low rate of culture-negative IE, high rate of definite IE without detected vegetations and predominance of S. aureus.

Keywords: Infective endocarditis; Staphylococcus aureus; elderly population; predictors for in-hospital mortality; proactive infectious diseases consultation.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Endocarditis, Bacterial / diagnosis
  • Endocarditis, Bacterial / microbiology
  • Endocarditis, Bacterial / mortality*
  • Female
  • Hospital Mortality
  • Humans
  • Japan
  • Male
  • Methicillin-Resistant Staphylococcus aureus
  • Middle Aged
  • Retrospective Studies
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / mortality
  • Staphylococcus aureus / isolation & purification
  • Tertiary Care Centers