Clinical and epidemiological profile of infective endocarditis in Chile - A systematic review of descriptive analysis

Background

Infective endocarditis (IE) is still a complex disease despite advances in modern medicine, with diverse epidemiology and clinical manifestation, and poor prognosis. Several recommendations have recently been published but it is uncertain if they can be extrapolated to every country.

Objectives

To describe our national clinical and epidemiological profile on IE.

Methodology

A systematic search through PubMed, Scielo, and abstracts book of Chilean Congress since 2012. Studies assessing adult patients with IE from Chile reporting information related to epidemiology, clinical manifestation, treatment, and complications have also been consulted.

Results

Ten registries were included. The mean age was 53.9-year-old, and most cases were male (64 %) with arterial hypertension (42 %). Most cases were from the central and southern zones of Chile. The most frequent clinical symptoms were fever and heart failure, with acute presentation (63.5 %), aortic valve (72.2 %), and native valve involvement (83.7 %). Predominantly, it was medical treatment over surgical treatment (57.7 versus 42.3 %), with main surgical indications due to local cardiac complications (66 %) and heart failure related (65.9 %). Complications included mechanical valve damage in 24.7 %, and embolism in 27.7 %. Staphylococcus sp. (28 %) was the predominant microorganism, particularly Staphylococcus aureus, and negative microbiological studies were seen in 34 %. In-hospital mortality was 24.8 %, whereas global mortality was 33.3 %.

Conclusion

This systematic review highlights epidemiological and clinical aspects of IE across Chile, such as acute presentation, predominance of aortic valve involvement, and S. aureus infection. However, there is a lack of prospective registries, therefore reflecting the need to collect richer information.