Abstract 9865: A Validated, Simplified Risk Model for Predicting 6-Month Mortality in Infective Endocarditis

Park, Larry; Chu, Vivian H.; Peterson, Gail; Skoutelis, Athanasios; Lejko‐Zupa, Tatjana; Bouza, Emilio; Tebini, Alessandro; Tattevin, Pierre; Habib, Gilbert; Tan, R.; Gonzalez, Javier; Altclas, Javier; Edathodu, Jameela; Fortes, Cláudio Querido; Siciliano, Rinaldo Focaccia; Pachirat, Orathai; Kanj, Souha S.; Wang, Andrew

doi:10.1161/circ.132.suppl_3.9865

Cited by 9 publications

(15 citation statements)

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“…Infective endocarditis remains a lethal disease. The in-hospital mortality for infective endocarditis approximates 20% and the 6-month mortality is about 30% . Despite advances in care, this mortality rate has not improved in the last 2 decades.…”

Section: Methodsmentioning

confidence: 99%

“…The persistently high mortality is due to epidemiological shifts in the types of infective endocarditis (eg, health care–associated infective endocarditis), greater numbers of older patients who have significant comorbidities, and pathogens that have greater antibiotic resistance (Box 4). Prognostic factors for poor outcomes from infective endocarditis include host factors such as age and hemodialysis, infective endocarditis characteristics like prosthetic valve involvement or health care associated infective endocarditis, and having complications of infective endocarditis such as severe heart failure, stroke, or abscess development . Early surgical intervention is associated with lower mortality, although patients with higher operative risk have poorer long-term survival than patients with lower operative risk .…”

Section: Methodsmentioning

confidence: 99%

“…Prognostic factors for poor outcomes from infective endocarditis include host factors such as age and hemodialysis, infective endocarditis characteristics like prosthetic valve involvement or health care associated infective endocarditis, and having complications of infective endocarditis such as severe heart failure, stroke, or abscess development . Early surgical intervention is associated with lower mortality, although patients with higher operative risk have poorer long-term survival than patients with lower operative risk . Patients with infective endocarditis have higher rates of all adverse cardiovascular events including stroke, myocardial infarction, rehospitalization for heart failure, and sudden death or ventricular arrhythmia compared with a matched cohort …”

Section: Methodsmentioning

confidence: 99%

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Management Considerations in Infective Endocarditis

Wang

Gaca

Chu

2018

JAMA

273

209

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ndocarditis is an infection of the cardiac endothelium and can present as either acute or subacute disease. Acute infective endocarditis advances rapidly, presenting with a sudden onset of high fever, rigors, sepsis, and systemic complications. This presentation alone is indistinguishable from other causes of sepsis, but when there is also a new-onset heart murmur, a diagnosis of acute infective endocarditis should be considered. In contrast, subacute infective endocarditis can be difficult to diagnose. Patients develop nonspecific symptoms such as fatigue, dyspnea, or weight loss over several weeks to months. Fever may or may not be present. Although endocarditis is commonly associated with a heart murmur due to valve regurgitation, new murmurs are present in less than half of cases (Table 1). 1,2 Janeway lesions or Osler nodes are classic diagnostic findings (Figure 1), but they are present in fewer than 5% of cases. Imaging can reveal embolic phenomena such as pulmonary and splenic emboli (Figure 2). Infective endocarditis should be suspected when patients present with either an acute or subacute illness when infective endocarditis risk factors are present (Box 1). In general, Staphylococcus aureus infection causes acute, aggressive infections, and the more indolent pathogens, viridans group streptococci or coagulase-negative staphylococci, cause subacute infective endocarditis. MethodsWe conducted a literature search of the PubMed database from January 2008 through March 2018. The selection, including clinical trials, observational studies, review articles, and society guidelines, was limited to studies published in English. We reviewed the reference articles that were cited in the guidelines IMPORTANCE Infective endocarditis occurs in approximately 15 of 100 000 people in the United States and has increased in incidence. Clinicians must make treatment decisions with respect to prophylaxis, surgical management, specific antibiotics, and the length of treatment in the setting of emerging, sometimes inconclusive clinical research findings.OBSERVATIONS Community-associated infective endocarditis remains the predominant form of the disease; however, health care accounts for one-third of cases in high-income countries. As medical interventions are increasingly performed on older patients, the disease incidence from cardiac implanted electronic devices is also increasing. In addition, younger patients involved with intravenous drug use has increased in the past decade and with it the proportion of US hospitalization has increased to more than 10%. These epidemiological factors have led to Staphylococcus aureus being the most common cause in high-income countries, accounting for up to 40% of cases. The mainstays of diagnosis are still echocardiography and blood cultures. Adjunctive imaging such as cardiac computed tomographic and nuclear imaging can improve the sensitivity for diagnosis when echocardiography is not conclusive. Serological studies, histopathology, and polymerase chain reaction assays have distinct ro...

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Management Considerations in Infective Endocarditis

Wang

Gaca

Chu

2018

JAMA

273

209

View full text Add to dashboard Cite

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“…173 Consequently, renal failure is part of several scoring systems for prediction of outcomes in infective endocarditis. 59,174–176…”

Section: Management Of Organ Dysfunctionmentioning

confidence: 99%

“…16 A number of risk factors predict outcome in infective endocarditis, especially when surgical treatment is indicated. Patient-and disease-related factors as well as infective endocarditis-mediated complications increasing the risk of mortality have been described 16,20,[56][57][58][59][60][61][62][63][64][65][66] (table 3). The abundance of such risk factors may lead to poor prognosis, and due to the inability to withstand the surgical hit, this could be a reason to avoid surgery.…”

Section: Prediction Of Outcomementioning

confidence: 99%

Anesthesia Considerations in Infective Endocarditis

et al. 2022

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The management of infective endocarditis is complex and inherently requires multidisciplinary cooperation. About half of all patients diagnosed with infective endocarditis will meet the criteria to undergo cardiac surgery, which regularly takes place in urgent or emergency settings. The pathophysiology and clinical presentation of infective endocarditis make it a unique disorder within cardiac surgery that warrants a thorough understanding of specific characteristics in the perioperative period. This includes, among others, echocardiography, coagulation, bleeding management, or treatment of organ dysfunction. In this narrative review article, the authors summarize the current knowledge on infective endocarditis relevant for the clinical anesthesiologist in perioperative management of respective patients. Furthermore, the authors advocate for the anesthesiologist to become a structural member of the endocarditis team.

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Safety of bacteriophage therapy in severe Staphylococcus aureus infection

et al. 2020

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Is intravenous (IV) administration of investigational bacteriophage (phage) therapy safe and well-tolerated in patients with severe Staphylococcus aureus infection?Findings: Thirteen patients with severe S. aureus infections received AB-SA01, a bacteriophage product prepared according to Good Manufacturing Practices (GMP), as adjunctive therapy to antibiotics. AB-SA01 was well-tolerated with no adverse events identified. Bacterial burden and inflammatory responses were reduced and no phage-resistant staphylococci were isolated during or after therapy.Meaning: Our results will inform future randomised controlled trials assessing the antibacterial and anti-inflammatory potential of bacteriophages in the treatment of severe S. aureus infection.

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Abstract 9865: A Validated, Simplified Risk Model for Predicting 6-Month Mortality in Infective Endocarditis

Cited by 9 publications

References 0 publications

Management Considerations in Infective Endocarditis

Management Considerations in Infective Endocarditis

Anesthesia Considerations in Infective Endocarditis

Safety of bacteriophage therapy in severe Staphylococcus aureus infection

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