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  1. Article ; Online: The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis.

    Almeida, Bianca Leal de / Strabelli, Tania Mara Varejao / Bittencourt, Marcio Sommer / Oliveira, Vítor Falcão de / Gualandro, Danielle Menosi / Mansur, Alfredo Jose / Tarasouchi, Flavio / Pocebon, Lucas / Paixão, Milena / Goldemberg, Flora / Salomão, Reinaldo / Siciliano, Rinaldo Focaccia

    Tropical medicine and infectious disease

    2024  Volume 9, Issue 1

    Abstract: 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 ... ...

    Abstract 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
    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.
    Language English
    Publishing date 2024-01-16
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2414-6366
    ISSN (online) 2414-6366
    DOI 10.3390/tropicalmed9010023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Changing trends in clinical characteristics and in-hospital mortality of patients with infective endocarditis over four decades.

    Santos, Diego Augusto Medeiros / Siciliano, Rinaldo Focaccia / Besen, Bruno Adler Maccagnan Pinheiro / Strabelli, Tania Mara Varejão / Sambo, Caio Trevelin / Milczwski, Vitor de Medeiros / Goldemberg, Flora / Tarasoutchi, Flavio / Vieira, Marcelo Luiz Campos / Paixão, Milena Ribeiro / Gualandro, Danielle Menosi / Accorsi, Tarso Augusto Duenhas / Pomerantzeff, Pablo Maria Alberto / Mansur, Alfredo José

    Journal of infection and public health

    2024  Volume 17, Issue 4, Page(s) 712–718

    Abstract: 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) ...

    Abstract 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.
    MeSH term(s) Humans ; Male ; Adult ; Middle Aged ; Female ; Endocarditis, Bacterial/surgery ; Hospital Mortality ; Coagulase ; Heart Valve Prosthesis/adverse effects ; Prosthesis-Related Infections/epidemiology ; Endocarditis/epidemiology ; Staphylococcus ; Staphylococcal Infections/complications
    Chemical Substances Coagulase
    Language English
    Publishing date 2024-03-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2467587-8
    ISSN 1876-035X ; 1876-0341
    ISSN (online) 1876-035X
    ISSN 1876-0341
    DOI 10.1016/j.jiph.2024.02.017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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