Variables % or Mean ±SD | <50 years old n = 205 (50.6%) | 50-64 years old n = 141 (34.8%) | ≥65 years old n = 59 (14.6%) | P value |
---|---|---|---|---|
Clinical data | ||||
Male | 127 (62.0) | 93 (66.0) | 41 (69.5) | .508 |
Age | 35 ± 9 | 57 ± 4 | 72 ± 5 | P<0.001 |
Hospital stay | 24 ±19 | 28 ±27 | 23 ±19 | .295 |
Duration of symptoms before echocardiography | 30 ± 37 | 24 ± 27 | 24 ± 34 | .174 |
Duration of symptoms before diagnosis | 42 ± 39 | 42 ± 44 | 42 ± 58 | .991 |
Time interval from diagnosis to surgery | 23.5 (8–55.5) | 16 (6.5–54) | 30 (11.5–64) | .322 |
Time interval from embolism to diagnosis | 4 ± 3 | 13 ± 17 | 11 ± 10 | .001 |
Time interval from cerebral embolism to diagnosis | 4 ± 2 | 16 ± 21 | 13 ± 12 | .006* |
IE localization | ||||
Native valve | 191 (93.2) | 128 (90.8) | 49 (83.1) | .059 |
Mitral | 61 (30.0) | 44 (31.2) | 15 (25.4) | |
Aortic | 54 (26.3) | 56 (40.0) | 18 (30.5) | |
Mitro-aortic | 31 (15.1) | 17 (12.1) | 8 (13.5) | |
Right valves | 23 (11.2) | 2 (1.4) | 4 (6.8) | |
Prosthetic valve | 13 (6.3) | 10 (7.1) | 8 (13.6) | .176 |
Mitral | 4 (2.0) | 4 (2.8) | 3 (5.1) | |
Aortic | 5 (2.4) | 4 (2.8) | 3 (5.1) | |
Mitro-aortic | 1 (0.5) | 0 | 1 (1.7) | |
Pacemaker | 1 (0.5) | 3 (2.1) | 2 (3.4) | .191 |
Community origin | 187 (91.2) | 124 (87.9) | 47 (79.7) | .050 |
Nosocomial origin | 3 (1.5) | 6 (4.3) | 6 (10.2) | .007 |
Comorbidities | ||||
Predisposing cardiac conditions | ||||
Rheumatic heart disease | 28 (13.7) | 30 (21.3) | 11 (18.6) | .169 |
Congenital heart disease | 71 (34.6) | 23 (16.3) | 10 (16.9) | P<0.001 |
Previous cardiac surgery | 16 (7.8) | 14 (9.9) | 14 (23.7) | .002 |
Degenerative heart disease | 1 (0.5) | 6 (4.3) | 6 (10.2) | .001 |
Chronic pulmonary disease | 1 (0.5) | 3 (2.1) | 2 (3.4) | .191 |
History of cancer | 3 (1.5) | 6 (4.3) | 2 (3.4) | .275 |
Hemodialysis | 3 (1.5) | 7 (5.0) | 4 (6.8) | .069 |
Liver cirrhosis | 2 (1.0) | 1 (0.7) | 1 (1.7) | .813 |
Hypertension | 14 (6.8) | 43 (30.5) | 25 (42.4) | P<0.001 |
Diabetes | 2 (1.0) | 25 (17.7) | 10 (16.9) | P<0.001 |
Intravenous drug abuse | 2 (1.0) | 0 | 1 (1.7) | .250 |
Immunodepression | 17 (8.3) | 12 (8.5) | 4 (6.8) | .915 |
Bad oral hygiene | 57 (27.8) | 45 (31.9) | 29 (49.2) | .008 |
Symptoms and signs | ||||
Fever | 186 (90.7) | 125 (88.7) | 53 (89.8) | .820 |
Anemia | 116 (56.6) | 68 (48.2) | 38 (64.4) | .085 |
Osler nodule | 5 (2.4) | 1 (0.7) | 1 (1.7) | .439 |
Janeway lesions or nailbed bleeding | 3 (1.5) | 1 (0.7) | 0 | .601 |
New or changing heart murmur | 172 (83.9) | 110 (78.0) | 45 (76.3) | .253 |
Hepatomegaly | 10 (4.9) | 9 (6.4) | 2 (3.4) | .658 |
Splenomegaly | 68 (33.2) | 28 (19.9) | 13 (22.0) | .015 |
Echocardiographic data | ||||
Vegetation length | .029 | |||
<10 mm | 35 (17.1) | 36 (25.5) | 18 (30.5) | |
≥ 10 mm | 146 (71.2) | 83 (58.9) | 30 (50.8) | |
No vegetation | 24 (11.7) | 22 (15.6) | 11 (18.6) | |
Vegetation mobility | 84 (41.0) | 47 (33.3) | 26 (44.1) | .238 |
Moderate or severe valve regurgitation | 29 (14.2) | 17 (12.4) | 12 (20.3) | .547 |
Moderate or severe valve stenosis | 11 (5.4) | 27 (19.7) | 5 (8.5) | .001 |
Abscess | 25 (12.2) | 17 (12.1) | 8 (13.6) | .953 |
Annular abscess | 13 (6.4) | 10 (7.1) | 7 (11.9) | .365 |
Pseudoaneurysm | 18 (8.8) | 7 (5.0) | 2 (3.4) | .207 |
Valvular perforation | 32 (15.8) | 27 (19.1) | 13 (22.0) | .480 |
Microbiology | ||||
Streptococci | 53 (25.9) | 34 (24.1) | 13 (22.0) | .819 |
Streptococcus viridans | 22 (10.7) | 9 (6.4) | 3 (5.1) | .219 |
Staphylococci | 40 (19.5) | 28 (19.9) | 11 (18.6) | .981 |
Staphylococcus aureus | 17 (8.3) | 9 (6.4) | 2 (3.4) | .405 |
Coagulase-negative staphylococci | 23 (11.2) | 19 (13.5) | 9 (15.3) | .660 |
Enterococci | 2 (1.0) | 2 (1.4) | 1 (1.7) | |
Fungi | 0 | 2 (1.4) | 1 (1.7) | |
Polymicrobial | 1 (0.5) | 1 (0.7) | 0 | |
Complications | ||||
Heart failure | 101 (49.3) | 76 (53.9) | 37 (62.7) | .181 |
Total emboli | 57 (27.8) | 45 (31.9) | 23 (39.0) | .247 |
Emboli under treatment | 60 (29.3) | 35 (24.8) | 12 (20.3) | .339 |
Intracranial infection | 12 (5.9) | 4 (2.8) | 1 (1.7) | .227 |
Cerebral emboli | 31 (15.1) | 29 (20.6) | 14 (23.7) | .219 |
Cerebral hemorrhage, | 14 (6.8) | 7 (5.0) | 2 (3.4) | .544 |
Arrhythmia | 24 (11.7) | 33 (23.4) | 23 (39.0) | P<0.001 |
Atrial fibrillation | 15 (7.3) | 29 (20.6) | 20 (33.9) | P<0.001 |
Apparition of atrioventricular block | 4 (2.0) | 4 (2.8) | 4 (6.8) | .155 |
Hepatic insufficiency | 43 (21.0) | 22 (15.6) | 6 (10.2) | .119 |
Renal insufficiency | 34 (16.6) | 29 (20.6) | 18 (30.5) | .061 |
Surgery and mortality | ||||
Surgical indication | 204 (99.5) | 140 (99.3) | 57 (96.6) | .142 |
Surgery indicated and performed | 128 (62.4) | 83 (58.9) | 24 (40.7) | .012 |
Reason of no surgery | ||||
Medical treatment | 61 (80.3) | 46 (80.7) | 23 (69.7) | |
Death before surgery | 12 (15.8) | 11 (19.3) | 10 (30.3) | .216 |
Patient’s refusal | 3 (3.9) | 0 | 0 | |
In-hospital mortality | 16 (7.8) | 15 (10.6) | 12 (20.3) | .023** |
One-year mortality | 18 (8.8) | 15 (10.6) | 12 (20.3) | .044 |
Cause of death | .124 | |||
Heart failure | 0 | 5 (33.3) | 3 (25.0) | |
Sepsis | 10 (55.6) | 6 (40.0) | 5 (41.7) | |
Cerebral hemorrhage Brain palsy | 6 (33.3) | 1 (6.7) | 2 (16.7) | |
Life-threatening arrhythmias | 1 (5.6) | 1 (6.7) | 1 (8.3) | |
Others | 1 (5.6) | 2 (13.3) | 1 (8.3) |