Endocarditis-TR: Diagnosis, treatment, and prognosis of the infective endocarditispatients admitting tertiary centres of Turkey

Authors

ALİ NAZMİ ÇALIK
FATMA ÖZLEM ARICAN ÖZLÜK
MEHMET BARAN KARATAŞ
YİĞİT ÇANGA
SEMİH EREN
GÖRKEM AYHAN
AYŞE SÜNBÜL
ALİ PALİCE
AYTAÇ CANDEMİR
ŞÜKRÜ AKYÜZ
MEHDİ ZOGHİ
ÖMER KOZAN

DOI

10.55730/1300-0144.5332

Abstract

Background/aim: Infective endocarditis (IE) is still a significant cause of morbidity and mortality among cardiovascular diseases. ENDOCARDITIS-TR study aims to evaluate the compliance of the diagnostic and therapeutic methods being used in Turkey with current guidelines. Materials and methods: The ENDOCARDITIS-TR trial is a multicentre, prospective, observational study consisting of patients admitted to tertiary centres with a definite diagnose of IE. In addition to the demographic, clinical, microbiological, and echocardiographic findings of the patients, adverse events, indications for surgery, and in-hospital mortality were recorded during a 2-year time interval. Results: A total of 208 IE patients from 7 tertiary centres in Turkey were enrolled in the study. The study population included 125 (60.1%) native valve IE (NVE), 65 (31.3%) prosthetic IE (PVIE), and 18 (8.7%) intracardiac device-related IE (CDRIE). One hundred thirty-five patients (64.9%) were culture positive, and the most frequent pathogenic agent was methicillin-susceptible Staphylococcus aureus (MSSA) (18.3%). Among 155 (74.5%) patients with an indication for surgery, only 87 (56.1%) patients underwent surgery. The all-cause mortality rate was 29.3% in-hospital follow-up. Multivariable Cox regression analysis revealed that absence of surgery when indicated (HR: 3.29 95% CI: 0.93-11.64 p = 0.05), albumin level at admission (HR: 0.46 95% CI: 0.29-0.73 P < 0.01), abscess formation (HR: 2.11 95% CI: 1.01-4.38 p = 0.04) and systemic embolism (HR: 1.78 95% CI: 1.05-3.02 p = 0.03) were ascertained independent predictors of in-hospital all-cause mortality. Conclusion: The short-term results of the ENDOCARDITIS-TR trial showed the high frequency of staphylococcal IE, relatively high in-hospital mortality rates, shortage of surgical treatment despite guideline-based surgical indications and low usage of novel imaging techniques. The results of this study will provide a better insight to physicians in respect to their adherence to clinical practice guidelines.

Keywords

Infective endocarditis, in-hospital mortality, heart valve disease

First Page

445

Last Page

455

Recommended Citation

ÇALIK, ALİ NAZMİ; ÖZLÜK, FATMA ÖZLEM ARICAN; KARATAŞ, MEHMET BARAN; ÇANGA, YİĞİT; EREN, SEMİH; AYHAN, GÖRKEM; SÜNBÜL, AYŞE; PALİCE, ALİ; CANDEMİR, AYTAÇ; AKYÜZ, ŞÜKRÜ; ZOGHİ, MEHDİ; and KOZAN, ÖMER (2022) "Endocarditis-TR: Diagnosis, treatment, and prognosis of the infective endocarditispatients admitting tertiary centres of Turkey," Turkish Journal of Medical Sciences: Vol. 52: No. 2, Article 20. https://doi.org/10.55730/1300-0144.5332
Available at: https://journals.tubitak.gov.tr/medical/vol52/iss2/20