Long-term follow-up of infective endocarditis: Rates of reinfection, mortality, and predictors of outcome
Mehmet Altunova, Recep Gulmez, Hicaz Zencirkiran Agus, Tugba Aktemur, Serpil Ozturk, Mehmet Koseoglu, Gamze Guler Babur, Ali Evsen, Yusuf Demir, Ugur Kokturk
article (Uluslararası, Hakemli) | Yazar(lar): Mehmet Altunova, Recep Gulmez, Hicaz Zencirkiran Agus, Tugba Aktemur, Serpil Ozturk, Mehmet Koseoglu, Gamze Guler Babur, Ali Evsen, Yusuf Demir, Ugur Kokturk | Yıl: 2024 | Dergi/Kurum: MARMARA MEDICAL JOURNAL | İndeks: WOS.ESCI | DOI: 10.5472/marumj.1573453 | Anahtar Kelime
Objective: Infective endocarditis (IE) is a severe condition characterized by high mortality rates. We aimed to assess reinfection and mortality rates in IE patients at a tertiary referral center during long-term follow-up. Patients and Methods: We retrospectively analyzed 204 patients meeting modified Duke criteria for definite IE between 2009 and 2019. Early reinfection was defined as occurrence within 6 months, and late reinfection was defined as occurrence 6 months after the initial diagnosis. Results: Mean follow-up duration was 40.3 +/- 26.4 months. Valve surgery was performed in 125 patients (69.8%), while 54 (30.2%) received medical therapy alone. Early reinfection was seen in 9 patients (5.1%), and late reinfection in 12 patients (6.7%). Staphylococci (41.9%), Streptococci (26.3%), and Enterococci (15.6%) were common pathogens. Peripheral limb emboli predicted reinfection (HR 4.118, 95% CI 1.471-11.528, p=0.007). Survival rates at 1, 2, and 5 years were 70.2%, 65.7%, and 57.3%, respectively. Age (HR 1.030, 95% CI 1.011 - 1.049, p=0.002), peripheral limb emboli (HR 2.994, 95% CI 1.509-5.940, p=0.002), and septic shock (HR 2.357, 95% CI 1.097-5.065, p=0.028) predicted mortality. Conclusion: Infective endocarditis mortality rates remain high regardless of reinfection. Peripheral limb emboli independently determine reinfection and mortality. Careful management of this group may reduce morbidity and mortality.