Infective endocarditis: prevalence, characteristics and mortality in Khon Kaen, 1990-1999.

ABSTRACT

OBJECTIVE: To update the prevalence, characteristics and mortality of infective endocarditis in a tertiary care hospital in Khon Kaen, Thailand. BACKGROUND: Numerous studies have shown that the prevalence and course of infective endocarditis remain unchanged inspite of the advance in treatment, diagnosis and of prophylactic recommendations. METHOD: The authors identified 160 patients from 1990-1999 with 86 per cent definite and 14 per cent possible endocarditis based on the Duke criteria. Data were collected from two tertiary care hospitals. RESULTS: The prevalence was 4 patients per 1,000 hospital admissions. The mean age of the 106 male and 54 female patients was 39+/-16 years. Twenty-four percent of the patients had no previously known heart disease. Native valve endocarditis was present in 95 per cent and prosthetic valve endocarditis was diagnosed in 5 per cent. Infective endocarditis was located on the aortic valve in 42 per cent, the mitral valve in 43 per cent, both mitral and aortic valves in 9 per cent and the tricuspid valve in 8 per cent. The infective organism was identified in only 62 per cent of cases. Streptococci was the most common in 43 per cent, followed by Staphylococci in 16 per cent. During the first month after admission, 45 per cent of the patients underwent surgery. In-hospital mortality was 25 per cent. CONCLUSION: Despite improved diagnostic techniques and aggressive surgical therapy, infective endocarditis remains a serious problem associated with a high mortality in Khon Kaen.