Predictors of Mortality in Infective Endocarditis: A Retrospective Study

Mina Boutgourine, Assala Cherki, Kawtar Bennajma, Joumana El Massrioui, M. E. Jamili, S. Karimi, M. Hattaoui
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Abstract

Introduction: Infective endocarditis (IE) remains a major health problem with significant morbidity and mortality rates. Despite its serious implications, data on prognostic factors remain scarce. Aim: We aim to determine predictive factors of mortality during infective endocarditis. Methods: We performed a retrospective study including patients admitted to university hospital Mohammed 6 of Marrakech between September 2019 and January 2024 for a confirmed IE based on Dukes modified criteria. Results: Of 43 patients included, 30 were males (69%) and 13 were females (30%). The mean age was 47.4 for men and 49.30 for women. 44.1% of our patients were admitted in heart failure, and 37% presented themselves late to our facility for management. Only 25.58% suffered from kidney failure and 55.8% presented an LV dysfunction. Complications were noted at a rate of 48%. Male’s group had less complication rate with 10% vs 38% in females’ group (p=0.042). And an overall mortality rate was at 34% and there were no significant sex related differences in terms of mortality between the two groups (33% in males vs 38% in females, p = 0.742). The analytical study concluded that heart failure at admission(p<0.001), neurological complications(p=0.024), anemia (p=0.049), kidney failure (p=0.002), prolonged antibiotics (p=0.016), LV dysfunction (p=0.027) and an emergency surgery (p<0.001) were independent risk factors for mortality. Conclusion: Our study underscores the urgent need to identify predictive factors of mortality in infective endocarditis (IE), and to adopt a multidisciplinary approach to enhance the care and management of patients, ultimately aiming to improve their survival rates.
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感染性心内膜炎死亡率的预测因素:回顾性研究
导言:感染性心内膜炎(IE)仍然是一个重大的健康问题,发病率和死亡率都很高。尽管其影响严重,但有关预后因素的数据仍然很少。目的:我们旨在确定感染性心内膜炎的预后因素。研究方法我们进行了一项回顾性研究,研究对象包括 2019 年 9 月至 2024 年 1 月期间在马拉喀什大学默罕默德 6 号医院住院的患者,这些患者根据杜克斯修改后的标准确诊为 IE。研究结果在纳入的 43 名患者中,男性 30 人(占 69%),女性 13 人(占 30%)。男性的平均年龄为 47.4 岁,女性为 49.30 岁。44.1%的患者因心力衰竭入院,37%的患者入院时间较晚。只有 25.58% 的患者患有肾衰竭,55.8% 的患者出现左心室功能障碍。并发症发生率为 48%。男性组的并发症发生率为 10%,女性组为 38%(P=0.042)。总死亡率为 34%,两组死亡率无明显性别差异(男性 33% 对女性 38%,P=0.742)。分析研究认为,入院时心力衰竭(p<0.001)、神经系统并发症(p=0.024)、贫血(p=0.049)、肾功能衰竭(p=0.002)、长期使用抗生素(p=0.016)、左心室功能障碍(p=0.027)和急诊手术(p<0.001)是导致死亡的独立风险因素。结论我们的研究强调,迫切需要确定感染性心内膜炎(IE)死亡率的预测因素,并采用多学科方法加强对患者的护理和管理,最终提高患者的存活率。
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