Echocardiographic Findings Predict In-Hospital and 1-Year Mortality in Left-Sided Native Valve
            <i>Staphylococcus aureus</i>
            Endocarditis

Lauridsen, Trine K.; Park, Lawrence; Tong, Steven Y. C.; Selton-Suty, Christine; Peterson, Gail; Cecchi, Enrico; Afonso, Luís; Habib, Gilbert; Paré, Carlos; Tamin, Syahidah Syed; Dickerman, Stuart; Bayer, Arnold S.; Johansson, Magnus C.; Chu, Vivian H.; Samad, Zainab; Bruun, Niels Eske; Fowler, Vance G.; Crowley, Anna Lisa

doi:10.1161/circimaging.114.003397

Cited by 43 publications

(12 citation statements)

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“…Overall, 15 included studies were from Europe [], six from Asia [ 32 33 34 35 36 37 ], one from Africa [ 38 ], and the remainder studies were intercontinental encompassing many countries [ 39 40 41 ]. We identified 14 retrospective and 11 prospective studies.…”

Section: Resultsmentioning

confidence: 99%

Short- and long-term outcomes in infective endocarditis patients: a systematic review and meta-analysis

Abegaz

Bhagavathula

Gebreyohannes

et al. 2017

BMC Cardiovasc Disord

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BackgroundDespite advances in medical knowledge, technology and antimicrobial therapy, infective endocarditis (IE) is still associated with devastating outcomes. No reviews have yet assessed the outcomes of IE patients undergoing short- and long-term outcome evaluation, such as all-cause mortality and IE-related complications. We conducted a systematic review and meta-analysis to examine the short- and long-term mortality, as well as IE-related complications in patients with definite IE.MethodsA computerized systematic literature search was carried out in PubMed, Scopus and Google Scholar from 2000 to August, 2016. Included studies were published studies in English that assessed short-and long-term mortality for adult IE patients. Pooled estimations with 95% confidence interval (CI) were calculated with DerSimonian-Laird (DL) random-effects model. Sensitivity and subgroup analyses were also performed. Publication bias was evaluated using inspection of funnel plots and statistical tests.ResultsTwenty five observational studies (retrospective, 14; prospective, 11) including 22,382 patients were identified. The overall pooled mortality estimates for IE patients who underwent short- and long-term follow-up were 20% (95% CI: 18.0–23.0, P < 0.01) and 37% (95% CI: 27.0–48.0, P < 0.01), respectively. The pooled prevalence of cardiac complications in patients with IE was found to be 39% (95%CI: 32.0–46.0) while septic embolism and renal complications accounted for 25% (95% CI: 20.0–31) and 19% (95% CI: 14.0–25.0) (all P < 0.01), respectively.ConclusionIrrespective of the follow-up period, a significantly higher mortality rate was reported in IE patients, and the burden of IE-related complications were immense. Further research is needed to assess the determinants of overall mortality in IE patients, as well as well-designed observational studies to conform our results.Electronic supplementary materialThe online version of this article (10.1186/s12872-017-0729-5) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Short- and long-term outcomes in infective endocarditis patients: a systematic review and meta-analysis

Abegaz

Bhagavathula

Gebreyohannes

et al. 2017

BMC Cardiovasc Disord

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“…Endocarditis is among the most feared complications of SAB with a reported incidence of 25–29% and a 1-year mortality rate up to 43% [ 3 , 15 , 24 ]. This complication is difficult to diagnose since the initial clinical symptoms and signs are insensitive and non-specific [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Staphylococcus aureus bacteraemia (SAB) is associated with a long hospital stay, a high morbidity and high 30-day mortality numbers ranging from 10 to 30% [ 1 , 2 ]. The mortality is associated with the development of serious complications such as metastatic abscesses, vertebral osteomyelitis and acutely life-threatening complications such as endocarditis, intracardiac abscesses and valve perforation [ 3 ]. Important in the management of SAB is to correctly classify SAB as either uncomplicated or complicated and to detect the complications as quickly as possible.…”

Section: Introductionmentioning

confidence: 99%

Implementing a hospital-wide protocol for Staphylococcus aureus bacteremia

Bolhuis

Bakker

Keijer

et al. 2018

Eur J Clin Microbiol Infect Dis

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Staphylococcus aureus bacteraemia (SAB) is associated with high-mortality and complication rates. A multidisciplinary approach is needed to predict, detect and treat complications. In this pre- and post-intervention study, we investigated the effects of a hospital-wide protocol for diagnosis, classification and treatment of SAB. It was hypothesized that complications and endocarditis would be better identified and treated. Medical records of SAB patients admitted in 2011 and 2012 (pre) were analysed. In 2013, a protocol, describing risk factors, diagnostic classification and recommended treatment, was implemented. In 2014 and 2015 (post), SAB patients were followed prospectively. Transthoracic (TTE) or transoesophageal cardiac ultrasound (TEE) was chosen following a decision tree. A resident internal medicine acted as contact person. Pre-intervention, 98 patients were eligible for analysis compared to 85 patients post-intervention. Age and number of risk factors were slightly higher post-intervention; other baseline characteristics were similar. Most SAB-patients were classified as complicated (89 and 82% pre- and post-intervention, respectively). Follow-up blood cultures drawn within 2 days after initiating treatment increased from 51 to 85%. Cardiac ultrasounds increased from 44 to 83% for TTE and 13 to 24% for TEE. Endocarditis was more frequently diagnosed (4 vs. 12%). Additionally, duration of antibiotic therapy increased. The 3-month mortality did not change significantly (33% pre-intervention vs. 35% post-intervention; p > 0.05). Introduction of a hospital-wide protocol for SAB management increased standard of care, created awareness among clinicians to properly classify SAB, search for endocarditis and adapt duration of antibiotic treatment. Mortality did not decrease.

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“…They found a one-year all-cause mortality of 56.3% among all IE cases. In a study from the International Collaboration on Endocarditis-cohort, Lauridsen et al reported the all-cause one-year mortality among patients with left-sided native valve S. aureus endocarditis to 43%, which is consistent with the current non-ESKD population [35]. Hemodialysis patients were not excluded in the study by Lauridsen et al, but only accounted for 12% of their population.…”

Section: Discussionmentioning

confidence: 82%

The impact of hemodialysis on mortality risk and cause of death in Staphylococcus aureus endocarditis

et al. 2018

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BackgroundThe risk of infective endocarditis (IE) is markedly increased in patients receiving chronic hemodialysis compared with the general population, but outcome data are sparse. The present study investigated causes and risk factors of mortality in a hemodialysis-treated end-stage kidney disease- (ESKD) and a non-ESKD population with staphylococcus (S.) aureus endocarditis.MethodsHemodialysis-treated ESKD patients with S. aureus endocarditis were identified from Danish National Registries and Non-ESKD patients from The East Danish Database on Endocarditis. For establishing the cause of death The Danish Registry of Cause of Death was used. Independent risk factors of outcome were identified in multivariable Cox regression models.ResultsOne hundred twenty-one hemodialysis patients and 190 non-ESKD patients with S. aureus endocarditis were included during 1996–2012 and 2002–2012, respectively. The all-cause in-hospital mortality was 22.3% in hemodialysis- and 24.7% in non-ESKD patients. One-year mortality, excluding in-hospital mortality, was 26.4% in hemodialysis patients and 15.2% in non-ESKD patients.The hazard ratio of all-cause mortality in hemodialysis was 2.64 (95% CI 1.70–4.10) at > 70 days after admission compared with non-ESKD. Age (HR 1.03 (95% CI 1.02–1.04)) and diabetes mellitus (HR 2.17 (95% CI 1.54–3.10)) were independent risk factors of all-cause mortality. The hazard ratio of cardiovascular death in hemodialysis was 3.20 (95% CI 1.78–5.77) at > 81 days after admission compared with non-ESKD. Age and diabetes mellitus were independently related to cardiovascular death.ConclusionAll-cause in-hospital mortality rates were similar in hemodialysis and non-ESKD patients with S. aureus endocarditis whereas one-year mortality rates were significantly increased in the hemodialysis population.Electronic supplementary materialThe online version of this article (10.1186/s12882-018-1016-0) contains supplementary material, which is available to authorized users.

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Echocardiographic Findings Predict In-Hospital and 1-Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis

Cited by 43 publications

References 24 publications

Short- and long-term outcomes in infective endocarditis patients: a systematic review and meta-analysis

Short- and long-term outcomes in infective endocarditis patients: a systematic review and meta-analysis

Implementing a hospital-wide protocol for Staphylococcus aureus bacteremia

The impact of hemodialysis on mortality risk and cause of death in Staphylococcus aureus endocarditis

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