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1.
Trop Med Infect Dis ; 9(1)2024 Jan 16.
Artículo en Inglés | MEDLINE | ID: mdl-38251219

RESUMEN

BACKGROUND: As infective endocarditis has particular characteristics compared to other infectious diseases, it is not clear if sepsis scores are reported with good accuracy in these patients. The aim of this study is to evaluate the accuracy of the qSOFA and SOFA scores to predict mortality in patients with infective endocarditis. METHODS: Between January 2010 and June 2019, 867 patients with suspected left-sided endocarditis were evaluated; 517 were included with left-sided infective endocarditis defined as "possible" or "definite" endocarditis, according to the Modified Duke Criteria. ROC curves were constructed to assess the accuracy of qSOFA and SOFA sepsis scores for the prediction of in-hospital mortality. RESULTS: The median age was 57 years, 65% were male, 435 (84%) had pre-existing heart valve disease, and the overall mortality was 28%. The most frequent etiologies were Streptococcus spp. (36%), Enterococcus spp. (10%), and Staphylococcus aureus (9%). The sepsis scores from the ROC curves used to predict in-hospital mortality were qSOFA 0.601 (CI95% 0.522-0.681) and SOFA score 0.679 (CI95% 0.602-0.756). A sub-group analysis in patients with and without pre-existing valve disease for SOFA ≥ 2 showed ROC curves of 0.627 (CI95% 0.563-0.690) and 0.775 (CI95% 0.594-0.956), respectively. CONCLUSIONS: qSOFA and SOFA scores were associated with increased in-hospital mortality in patients with infective endocarditis. However, as accuracy was relatively lower compared to other sites of bacterial infections, we believe that this score may have lower accuracy when predicting the prognosis of patients with IE, because, in this disease, the patient's death may be more frequently linked to valvular and cardiac dysfunction, as well as embolic events, and less frequently directly associated with sepsis.

2.
J Infect Public Health ; 17(4): 712-718, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38484416

RESUMEN

BACKGROUND: Infective endocarditis continues to be a significant concern and may be undergoing an epidemiological transition. METHODS: Were studied 1804 consecutive episodes of infective endocarditis between 1978 and 2022. The mean age was 48 ( ± 19), and 1162 (64%) patients were male. Temporal trends in demographic data, comorbidities, predisposing conditions, microorganisms, complications and in-hospital death have been studied over the decades (1978-1988, 1989-1999, 2000-2010 and 2011-2022). The outcomes and clinical characteristics were modeled using nonlinear cubic spline functions. FINDINGS: Valve surgery was performed in 50% of the patients and overall in-hospital mortality was 30%. From the first to the fourth decade studied, the average age of patients increased from 29 to 57 years (p < 0.001), with significant declines in the occurrence of rheumatic valvular heart disease (15% to 6%; p < 0.001) and streptococcal infections (46% to 33%; p < 0.001). Healthcare-associated infections have increased (9% to 21%; p < 0.001), as have prosthetic valve endocarditis (26% to 53%; p < 0.001), coagulase-negative staphylococcal infections (4% to 11%; p < 0.001), and related-complications (heart failure, embolic events, and perivalvular abscess; p < 0.001). These changes were associated with a decline in adjusted in-hospital mortality from 34% to 25% (p = 0.019). INTERPRETATION: In the 44 years studied, there was an increase in the mean age of patients, healthcare-related, prosthetic valve, coagulase-negative staphylococci/MRSA infections, and related complications. Notably, these epidemiological changes were associated with a decline in the adjusted in-hospital mortality.


Asunto(s)
Endocarditis Bacteriana , Endocarditis , Prótesis Valvulares Cardíacas , Infecciones Relacionadas con Prótesis , Infecciones Estafilocócicas , Humanos , Masculino , Adulto , Persona de Mediana Edad , Femenino , Endocarditis Bacteriana/cirugía , Mortalidad Hospitalaria , Coagulasa , Prótesis Valvulares Cardíacas/efectos adversos , Infecciones Relacionadas con Prótesis/epidemiología , Endocarditis/epidemiología , Staphylococcus , Infecciones Estafilocócicas/complicaciones
3.
Diagn. tratamento ; 28(2): 71-72, abr-jun. 2023.
Artículo en Portugués | LILACS, SES-SP | ID: biblio-1427629

RESUMEN

Perguntas dizem respeito ao autor da pergunta, ao profissional que as recebe, em diferentes categorias: significado verbalizado ou implícito; nível de elaboração; especificidade de conteúdo e a possibilidade de resposta, entre outras. Nos tempos atuais de transmissão rápida, imediata e viral de informações, talvez uma dimensão adicional 2,3 ­ a demanda por resposta imediata. Seguem reflexões sobre as perguntas recebidas nesse contexto da prática...


Asunto(s)
Personal de Salud
4.
Diagn. tratamento ; 29(2): 45-47, abr-jun. 2024.
Artículo en Portugués | LILACS, SES-SP | ID: biblio-1553881

Asunto(s)
Pensamiento
5.
Diagn. tratamento ; 29(3): 97-99, jul-set. 2024.
Artículo en Portugués | LILACS, SES-SP | ID: biblio-1561624

Asunto(s)
Creatividad
8.
Diagn. tratamento ; 28(3): 112-3, jul-set de 2023.
Artículo en Portugués | LILACS, SES-SP | ID: biblio-1517917
9.
Diagn. tratamento ; 28(4): 154-156, out-dez/2023.
Artículo en Portugués | LILACS | ID: biblio-1532338

Asunto(s)
Métodos
11.
Diagn. tratamento ; 27(3): 85-6, jul-set. 2022.
Artículo en Portugués | LILACS | ID: biblio-1380675

Asunto(s)
Ejercicio Físico
12.
Diagn. tratamento ; 27(4): 130-2, out-dez. 2022.
Artículo en Portugués | LILACS | ID: biblio-1399032

Asunto(s)
Estética
13.
Diagn. tratamento ; 27(2): 39-41, abr-jun. 2022.
Artículo en Portugués | LILACS | ID: biblio-1369108

Asunto(s)
Asertividad
14.
Diagn. tratamento ; 26(1): 21-23, jan.-mar. 2021.
Artículo en Portugués | LILACS | ID: biblio-1247976
15.
Diagn. tratamento ; 26(2): 73-74, abr.-jun. 2021.
Artículo en Portugués | LILACS | ID: biblio-1280727

Asunto(s)
Comunicación
16.
Diagn. tratamento ; 26(4): 144-6, out-dez. 2021.
Artículo en Portugués | LILACS | ID: biblio-1348613
17.
Diagn. tratamento ; 26(3): 108-10, jul-set. 2021.
Artículo en Portugués | LILACS | ID: biblio-1291197
20.
Diagn. tratamento ; 25(3): 104-105, jul.-set. 2020.
Artículo en Portugués | LILACS | ID: biblio-1129412

Asunto(s)
Lenguaje
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