| Abstract | CILJ: Utvrditi osobine i ishode bolesnika liječenih zbog infekcijskog endokarditisa (IE) u Kliničkom bolničkom centru Split, u razdoblju od 1. siječnja 2012. do 31. prosinca 2020.
ISPITANICI I METODE: U retrospektivno presječno istraživanje je uključen 101 bolesnik s dijagnozom IE potvrđenom temeljem modificiranih Dukeovih kriterija. Analizirani su klinički i demografski podatci, ranije bolesti, primjena lijekova s imunosupresivnim učinkom, intravenska primjena droga, simptomi prilikom prijama, vrijednosti hematoloških i biokemijskih pokazatelja, nalazi mikrobiološke obrade, trajanje i ishodi (otpust, premještaj na kardiokirurgiju, smrt) liječenja.
REZULTATI: Najčešći čimbenici srčano-žilnog rizika bili su arterijska hipertenzija (35,6%), pušenje (22,8%) i kronično zatajivanje bubrega (13,1%); u 7,9% bolesnika zabilježena je intravenska primjena opojnih sredstava. Najčešći simptomi zabilježeni prilikom prijama bolesnika bili su: povišena tjelesna temperatura (92,1%) i novonastali ili pojačan intenzitet od ranije poznatog srčanog šuma (77%). Najčešće zahvaćeni prirodni zalistak je bio mitralni (30,69%) a umjetni aortni (16,38%). Najčešći uzročnici IE bili su Streptococcus viridans (23,76%), meticilin osjetljivi Staphylococcus aureus (22,76%) i enterokok (16,83%); negativan nalaz hemokultura je zabilježen u 15,84% bolesnika. U liječenju su najčešće korišteni beta-laktamski antibiotici (87,12%), gentamicin (47,52%) i vankomicin (17,8%). Na kućno liječenje otpušteno je 62,4% bolesnika, 22,7% bolesnika je podvrgnuto kardiokirurškom zahvatu, u 14,9% bolesnika zabilježen je smrtni ishod. Jedini nezavisni prediktor smrti bila je dob bolesnika >65 g (p<0,001).
ZAKLJUČCI: Karakteristike naših bolesnika su podudarne, a ishodi bolesnika povoljniji u odnosu na rezultate zabilježene u ustanovama iste razine u zemljama zapadnog svijeta. Jedini nezavisni pretkazatelj smrti u naših bolesnika s IE bila je dob veća od 65 godina. |
| Abstract (english) | OBJECTIVE: To determine the characteristics and outcomes of patients treated for infectious endocarditis (IE) at the University Hospital of Split, in the period from 1 January 2012 to 31 December 2020.
PATIENTS AND METHODS: A retrospective cross-sectional study included 101 patients with a diagnosis of IE confirmed based on modified Duke criteria. Clinical and demographic data, previous diseases, administration of drugs with immunosuppressive effect, intravenous drug use, symptoms on admission, values of hematological and biochemical parameters, microbiological processing findings, duration and outcomes (discharge, cardiac surgery, death) were analyzed.
RESULTS: The most common cardiovascular risk factors were arterial hypertension (35.6%), smoking (22.8%), and chronic renal failure (13.1%); intravenous administration of narcotics was reported in 7.9% of patients. The most common symptoms observed on admission were: fever (92.1%) and new or increased intensity of previously known cardiac murmur (77%).
The most commonly affected natural valve was the mitral valve (30.69%); the most commonly affected artificial valve was the aortic (16.38%). The most common causes of IE were Streptococcus viridans (23.76%), Staphylococcus aureus sensitive to methicillin (22.76%) and enterococci (16.83%); a negative blood culture finding was noted in 15.84% of patients. Beta-lactam antibiotics (87.12%), gentamicin (47.52%) and vancomycin (17.8%) were most commonly used in treatment. 62.4% of patients were discharged for home treatment, 22.7% of patients underwent cardiac surgery, and 14.9% of patients had a fatal outcome. The only independent predictor of death was the patient's age > 65 years (p <0.001).
CONCLUSIONS: The characteristics of our patients are consistent and the outcomes of patients are more favorable compared to the results recorded in institutions of the same level in the countries of the Western world. The only independent predictor of death in our IE patients was age greater than 65 years. |
