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  • Murdoch, David R (author)

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

  • Article/chapterEnglish2009

Publisher, publication year, extent ...

  • American Medical Association (AMA),2009

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  • LIBRIS-ID:oai:gup.ub.gu.se/107632
  • https://gup.ub.gu.se/publication/107632URI
  • https://doi.org/10.1001/archinternmed.2008.603DOI

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  • Language:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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.

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  • Corey, G Ralph (author)
  • Hoen, Bruno (author)
  • Miró, José M (author)
  • Fowler, Vance G (author)
  • Bayer, Arnold S (author)
  • Karchmer, Adolf W (author)
  • Olaison, Lars,1949Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine(Swepub:gu)xolala (author)
  • Pappas, Paul A (author)
  • Moreillon, Philippe (author)
  • Chambers, Stephen T (author)
  • Chu, Vivian H (author)
  • Falcó, Vicenç (author)
  • Holland, David J (author)
  • Jones, Philip (author)
  • Klein, John L (author)
  • Raymond, Nigel J (author)
  • Read, Kerry M (author)
  • Tripodi, Marie Francoise (author)
  • Utili, Riccardo (author)
  • Wang, Andrew (author)
  • Woods, Christopher W (author)
  • Cabell, Christopher H (author)
  • Göteborgs universitetInstitutionen för biomedicin, avdelningen för infektionssjukdomar (creator_code:org_t)

Related titles

  • In:Archives of internal medicine: American Medical Association (AMA)169:5, s. 463-731538-36790003-9926

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