Clinical outcome of native valve infective endocarditis in Khon Kaen: 1990-1999.

OBJECTIVE: To compare the survival of infective endocarditis (IE) patients following different treatment strategies and to determine the predictors of patient survival. BACKGROUND: IE is a life-threatening infectious disease that is often difficult to manage. Studies on long-term outcome are limited. METHOD: Data on 152 patients with IE from 1990 to 1999 were collected from two hospitals. The main outcome is death after definite diagnosis of native valve IE. RESULTS: The overall case fatality rate was 38 per 100 patient-years. Survival curves showed better survival for patients treated with surgery compared with patients treated medically (p <0.0001). Survival rate at year 1 was 72 per cent for surgically treated patients and 33 per cent for medically treated patients. Five-year survival rates were 66 per cent and 27 per cent in the two groups, respectively. Based on Cox proportional hazards regression analysis, surgery to be an independent predictor of survival (relative risk [RR] = 0.23; 95% confidence interval [CI] 0.14 to 0.39, p < 0.0001), while the presence of congestive heart failure (RR = 2.55; 95% CI 1.61 to 4.02, p < 0.0001), and being male (RR = 1.76; 95% CI 1.04 to 2.82, p <0.05) were independent predictors of mortality. CONCLUSION: Patients with native valve endocarditis have a high long-term mortality rate. The most common types of cardiac death are post-operative and sudden death. Surgical treatment was the preventive factor of mortality.