Infective endocarditis in the Pacific: clinical characteristics, treatment and long-term outcomes.
Open Heart
; 2(1): e000183, 2015.
Article
em En
| MEDLINE
| ID: mdl-25973211
ABSTRACT
INTRODUCTION:
Data on clinical characteristics and outcomes of infective endocarditis (IE) in the Pacific are scarce.METHODS:
Retrospective hospital-based study in New Caledonia, a high-income country, on patients aged over 18â years with definite IE according to the modified Duke criteria (2005-2010).RESULTS:
51 patients were included 31 (60.8%) men; median age of 52.4â years (IQR 33.0-70.0). Left-sided IE accounted for 47 (92.2%) patients native valve IE in 34 (66.7%) and prosthetic valve IE in 13 (25.5%). The main underlying heart disease included rheumatic valve disease in 19 (37.3%), degenerative heart valve disease in 12 (23.5%) and congenital heart disease in 6 (11.8%). Significant comorbidities (Charlson's score >3) were observed in 20 (38.7%) patients. Infection was community acquired in 43 (84.3%) patients. Leading pathogens included Staphylococcus aureus in 16 (31.4%) and Streptococcus spp in 15 (29.4%) patients. Complications were noted in 33 patients (64.7%) and 24 (47.1%) were admitted to the intensive care unit. Cardiac surgery was eventually performed in 22 of 40 (55.0%) patients with a theoretical indication. None underwent emergent cardiac surgery (ie, first 24â h); 2 (3.9%) were operated within 7â days; and 20 (39.2%) beyond 7â days. 11 (21.6%) patients died in hospital and 21 (42.9%) were dead after a median follow-up of 28.8â months (IQR 4.6-51.2). Two (3.9%) were lost to follow-up.CONCLUSIONS:
In New Caledonia, IE afflicts relatively young patients with rheumatic heart disease, and carries high complication and mortality rates. Access to heart surgery remains relatively limited in this remote archipelago.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
Open Heart
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
França