Clinical Characteristics, Pathogenic Distribution, Treatment and Prognosis of 300 Patients With Infective Endocarditis Hospitalized in Fuwai Hospital / 中国循环杂志

ABSTRACT

Objectives: To analyze the clinical features, pathogenic distribution, treatment and prognosis of patients with infective endocarditis (IE) hospitalized in Fuwai Hospital during the latest 4 years, and to improve the diagnosis and treatment of this disease. Methods: This retrospective study included a cohort of 300 IE patients hospitalized in Fuwai Hospital from 2013 to 2016. Predisposing cardiac disease,pathogenic distribution and clinical outcomes were analyzed.Clinical and epidemiological features of patients treated with medications or surgery were compared. Results: There were 228 male and 72 female patients in this cohort; the mean age was (40.0±15.7) years old. Among the IE patients, 35.3% patients had congenital heart diseases, 22.3% had non-rheumatic valve diseases, and 10.3% had history of PCI or heart surgery. Only 4.3% patients suffered from rheumatic heart diseases. Cardiac murmur (93.3%) and fever (84.3%) were the most common clinical presentations. Congestive heart failure was the most common complication (75.3%), followed by systemic and pulmonary embolism (16.7%). Incidence of positive blood culture was 52.4%.Streptococcus (76.3%) were the most common causative organisms, followed by Staphylococcus (11.0%). 91.3% IE was detected by echocardiography. In-hospital mortality rate was 3.0%. Subgroup analysis showed that the cure rate of surgical treatment group was significantly higher than that of the medical treatment group (96.6% vs 48.6%, P<0.001). Conclusion: Congenital heart disease is the main underlying disease related to IE.Streptococcus is still the primary pathogen of IE. Due to the 1ower positive rate of blood culture, echocardiography serves as the most important diagnostic tool for infective endocarditis.Early, effective and regular antibiotic therapy is still the cornerstone of the treatment of IE. Cardiac surgery treatment can reduce the mortality rate of IE.