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Table 1 Comparison of clinical characteristics and outcomes of NNHCA-IE with community-acquired IE and nosocomial IE among patients admitted to the Veterans General Hospital Kaohsiung, Taiwan over a five-year period (2004 to 2009)

From: Non-nosocomial healthcare-associated infective endocarditis in Taiwan: an underrecognized disease with poor outcome

  All Group A:
NNHCA-IE
n = 30
Group B:
Community-acquired IE
n = 148
Group C:
Nosocomial IE
n = 22
Group
A vs B
pvalue
Group
A vs C
pvalue
Age, years       
   Median (range) 50 (19-92) 67 (45-84) 44 (19-88) 78 (43-92) < 0.001 0.011
Women, n (%) 48 (24.0) 13 (43.3) 28 (18.9) 7 (31.8) 0.004 0.399
Prosthetic valve, n (%) 18 (9.0) 2 (6.7) 15 (10.1) 1 (4.5) 0.741 1.000
Underlying diseases, n (%)       
   Predisposing heart condition 49 (24.5) 6 (20.0) 40 (27.0) 3 (13.6) 0.423 0.717
   Diabetes mellitus 52 (26.0) 17 (56.7) 25 (16.9) 10 (45.5) < 0.001 0.424
   Hypertension 54 (27.0) 20 (66.7) 26 (17.6) 8 (36.4) < 0.001 0.030
   Heart failure 35 (17.5) 4 (13.3) 25 (16.9) 6 (27.2) 0.789 0.290
   HIV infected 10 (5.0) 0 (0) 10 (6.8) 0 (0) 0.216 NA
IVDU 59 (29.5) 0 (0) 59 (40.0) 0 (0) < 0.001 NA
Charlson comorbidity index, median (IQR) 1 (0-2) 4 (2-6) 0 (0-1) 2 (1-4) < 0.001 0.06
   0-1 132 (66.0) 3 (10.0) 121 (81.8) 8 (36.4)   
   2-3 34 (17.0) 9 (30.0) 19 (12.8) 6 (27.3)   
   4 34 (17.0) 18 (60.0) 8 (5.4) 8 (36.4)   
Dental procedure 9 (4.5) 0 (0) 8 (5.4) 1 (4.5) 0.193 0.423
Symptom duration, days, median (IQR) 1 5 (3-15) 4 (2-7) 7 (3-20) NA 0.031 NA
Symptoms, n (%) 1       
   Constitutional 142 (71.0) 26 (86.7) 104 (70.3) 12 (54.5) 0.065 0.010
   Cardiopulmonary 65 (32.5) 6 (20.0) 50 (33.8) 9 (40.9) 0.138 0.100
   Neurological 47 (23.5) 4 (13.3) 40 (27.0) 3 (13.6) 0.113 1.000
   Gastrointestinal 14 (7.0) 3 (10.0) 8 (5.4) 3 (13.6) 0.399 0.689
   Musculoskeletal 24 (12.0) 5 (16.7) 19 (12.8) 0 (0) 0.563 0.065
Signs, n (%) 2       
   Fever 165 (82.5) 28 (93.3) 121 (81.8) 16 (72.7) 0.174 0.058
   Heart murmur 83 (41.5) 10 (33.3) 68 (45.9) 5 (22.7) 0.204 0.404
   Skin lesions 23 (11.5) 3 (10.0) 20 (13.5) 0 (0) 0.770 0.253
   Embolism 98 (49.0) 11 (36.7) 82 (55.4) 5 (22.7) 0.061 0.282
   Altered consciousness 34 (17.0) 4 (13.3) 28 (18.9) 2 (9.1) 0.468 1.000
   Shock 20 (10.0) 2 (6.7) 16 (10.8) 2 (9.1) 0.742 1.000
Recognition on admission, n (%) 3 68/162 (42.0) 5/30 (16.7) 63/132 (47.7) NA 0.002 NA
Appropriate antibiotics on admission, n (%) 4 94/165 (57.0) 13/30 (43.3) 81/135 (60.0) NA 0.095 NA
Outcome       
   Antibiotic treatment duration, median days (IQR, n) 5 32 (28-41, n = 138) 28 (27-40, n = 17) 32 (28-42, n = 113) 34 (30-40, n = 8) 0.258 0.277
Hospital stay, median days (IQR, n) 5 37 (29-48, n = 131) 46 (30-65, n = 17) 37 (29-45, n = 114) NA 0.181 NA
In-hospital death 50 (25.0) 15 (50.0) 26 (17.6) 9 (40.9) < 0.001 0.516
  1. 1 Duration from the time of onset of symptoms to admission to hospital.
  2. 2 Includes all symptoms and signs of IE from their onset to diagnosis.
  3. 3 The number of patients who were suspected or diagnosed to have IE within the first 24 hours of medical access. Exclude patients who were referred from other hospitals with a definite diagnosis already.
  4. 4 The number of patients who received antibiotics with in vitro activities against the pathogens within the first 24 hours of medical access.
  5. 5 Only patients who have received a complete course of antibiotics for IE were included.
  6. NNHCA-IE, non-nosocomial healthcare-associated infective endocarditis; HIV, human immunodeficiency virus; NA, not applicable; IVDU, intravenous drug user; IQR, interquartile range