Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w
Long-term follow-up after endocarditis at a large community hospital with on-site cardiac surgery
R. Zahn1, E. Taner1, C. Kilkowski1, A.-K. Karcher1, R. Winkler1, T. Kleemann1, D. Sutor1, U. Weisse1, F.-U. Sack2, S. Schneider3
1Medizinische Klinik B, Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen am Rhein; 2Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen am Rhein; 3IHF GmbH, Ludwigshafen am Rhein;

Background: Infective endocarditis (IE) is still a serious disease, with a high hospital mortality. However, data on long-term follow-up are sparse.

Methods: Retrospective single centre registry on the hospital course and long-term follow-up of patients with IE.

Results: Between 1/2013 and 12/2016, 171 IE patients were treated at our hospital. A follow-up with either patient contact, review of hospital charts or physician contact was performed in 2022. Due to lost to follow-up (n=4) and declined to participate after discharge (n=1), the final evaluation was performed with 166 patients (97.1%). They were followed-up for a median 2385,0 (between 2156,0 and 2773,0) days.

Numbers (%)

Age (years)

66.5±13.8

Women

43 (25.1%)

Previous valve replacements/interventions

63 (36.9%)

Positive blood cultures

137 (80.1%)

Gram positive strains

134 (97.8%)

native valve IE (NVE)

85 (49.7%)

prosthetic valve IE (PVE)

53 (31%)

intra-cardiac device related IE or IE associated with central access lines(DRE)

33 (19.3%)

In-hospital cardiac surgery

139 (81.3%)

Hospital mortality

37 (21.6%)

Follow-up (after median 2385 days)

166 (97.1%)

Calculated 1 year mortality

27.7%

Calculated 3 year mortality

43.4%

Calculated 5 year mortality

53.6%

Endocarditis related mortality

Probable/certain

68.2%

Uncertain

13.1%

Not related

18.7%

Re-hospitalisation for endocarditis

37.3%

Using a logistic regression model to analyse predictors of probable/certain IE related mortality during FU cardiac surgery versus medical treatment alone was not an independent predictor (OR: 1.53, 95%CI 0.61–3.7; p=0.37).

Conclusions

These data on long-term follow-up after IE show a high mortality, which was 53.6% after 5 years, despite a high rate of surgery. More than 2/3 of deaths were due to IE. Furthermore, rehospitalisation rate for recurrent IE was also high.
https://dgk.org/kongress_programme/jt2023/aV1237.html