Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study.

Murdoch, David R, Corey, G Ralph, Hoen, Bruno, Miró, Jose M, Fowler, Vance G, Bayer, Arnold S, Karchmer, Adolf W, Olaison, Lars, Pappas, Paul A, Moreillon, Philippe, Chambers, Stephen T, Chu, Vivian H, Falcó, Vicenc, Holland, David J, Jones, Philip, Klein, John L, Raymond, Nigel J, Read, Kerry M, Tripodi, Marie F, Utili, Riccardo, Wang, Andrew, Woods, Christopher W, Cabell, Christopher CH and International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators, 2009, Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study., Archives of internal medicine, vol. 169, no. 5, pp. 463-473, doi: 10.1001/archinternmed.2008.603.

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Title Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study.
Author(s) Murdoch, David R
Corey, G Ralph
Hoen, Bruno
Miró, Jose M
Fowler, Vance G
Bayer, Arnold S
Karchmer, Adolf W
Olaison, Lars
Pappas, Paul A
Moreillon, Philippe
Chambers, Stephen T
Chu, Vivian H
Falcó, Vicenc
Holland, David J
Jones, Philip
Klein, John L
Raymond, Nigel J
Read, Kerry M
Tripodi, Marie F
Utili, Riccardo
Wang, Andrew
Woods, Christopher W
Cabell, Christopher CH
International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators,
Journal name Archives of internal medicine
Volume number 169
Issue number 5
Start page 463
End page 473
Total pages 11
Publisher American Medical Association
Place of publication Chicago, IL.
Publication date 2009-03-09
ISSN 1538-3679
Keyword(s) International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators
Summary BACKGROUND: We sought to provide a contemporary picture of the presentation, etiology, and outcome of infective endocarditis (IE) in a large patient cohort from multiple locations worldwide. METHODS: Prospective cohort study of 2781 adults with definite IE who were admitted to 58 hospitals in 25 countries from June 1, 2000, through September 1, 2005. RESULTS: The median age of the cohort was 57.9 (interquartile range, 43.2-71.8) years, and 72.1% had native valve IE. Most patients (77.0%) presented early in the disease (<30 days) with few of the classic clinical hallmarks of IE. Recent health care exposure was found in one-quarter of patients. Staphylococcus aureus was the most common pathogen (31.2%). The mitral (41.1%) and aortic (37.6%) valves were infected most commonly. The following complications were common: stroke (16.9%), embolization other than stroke (22.6%), heart failure (32.3%), and intracardiac abscess (14.4%). Surgical therapy was common (48.2%), and in-hospital mortality remained high (17.7%). Prosthetic valve involvement (odds ratio, 1.47; 95% confidence interval, 1.13-1.90), increasing age (1.30; 1.17-1.46 per 10-year interval), pulmonary edema (1.79; 1.39-2.30), S aureus infection (1.54; 1.14-2.08), coagulase-negative staphylococcal infection (1.50; 1.07-2.10), mitral valve vegetation (1.34; 1.06-1.68), and paravalvular complications (2.25; 1.64-3.09) were associated with an increased risk of in-hospital death, whereas viridans streptococcal infection (0.52; 0.33-0.81) and surgery (0.61; 0.44-0.83) were associated with a decreased risk. CONCLUSIONS: In the early 21st century, IE is more often an acute disease, characterized by a high rate of S aureus infection. Mortality remains relatively high.
Language eng
DOI 10.1001/archinternmed.2008.603
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2009, American Medical Association
Persistent URL http://hdl.handle.net/10536/DRO/DU:30086770

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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