Alghamdi Saleh A, Alkhammash Abdulaziz M, Alotaibi Abdulrahman F, Bugshan Saeed A, Alshanbri Nawaf K, Zahrani Mohammed
College of Medicine, King Abdulaziz University, Jeddah, SAU.
Internal Medicine, King Abdulaziz University, Jeddah, SAU.
Cureus. 2021 Jun 28;13(6):e15983. doi: 10.7759/cureus.15983. eCollection 2021 Jun.
Introduction Infective endocarditis (IE) is a microbial infection affecting the endothelial lining of the heart chambers and valves. Despite advances in diagnostic methods and management, IE still carries high levels of morbidity and mortality. There are no comprehensive data describing incidence, risk factors, and outcomes of IE in Saudi Arabia. Our study aims to describe the epidemiological and clinical characteristics and outcomes of adult patients with IE treated in a tertiary, Teaching Hospital. Methods This is a descriptive, retrospective review of charts (between January 2003 and June 2019) conducted at King Abdulaziz University Hospital. We included all patients 16 years and older with a definitive diagnosis of IE based on Duke Criteria. We collected the following information: demographics, risk factors, comorbidities, microbial type, antibiotic choice, complications, laboratory data, echocardiography data, and mortality. Results We found a total of 60 adult patients with definitive diagnoses of IE: 55% of them were males, and the mean age was 48.71 ± 18.3 years. Hypertension was the most common comorbidity, affecting 23 patients (38.3%), followed by end-stage renal disease (ESRD) in 20 patients (33.3%) and diabetes in 17 (28.3%). was the most common organism (25%), and vancomycin was the most prescribed antibiotic. Fifty-eight patients were treated medically (96.5%). Furthermore, 88% of the patients had vegetations, detected by echocardiography, and the majority had single-valve involvement. Sepsis was the most common complication, and the mortality rate was 36.7%. Conclusion There was a small number of definitive IE cases over a 17-years span in our institution. Surprisingly, a higher mortality rate was found among our patients and a lower surgical intervention rate in comparison with the literature. Though we acknowledge the limitations of a retrospective, chart review study, we can speculate that the high mortality rate may be in part related to a higher number of virulent organisms, delayed presentation, and lack of prompt surgical intervention.
引言 感染性心内膜炎（IE）是一种影响心脏腔室和瓣膜内皮的微生物感染。尽管在诊断方法和治疗方面取得了进展，但IE的发病率和死亡率仍然很高。沙特阿拉伯没有关于IE发病率、危险因素和结局的综合数据。我们的研究旨在描述在一家三级教学医院接受治疗的成年IE患者的流行病学、临床特征和结局。方法 这是一项对阿卜杜勒阿齐兹国王大学医院（2003年1月至2019年6月）病历进行的描述性回顾性研究。我们纳入了所有16岁及以上根据杜克标准确诊为IE的患者。我们收集了以下信息：人口统计学、危险因素、合并症、微生物类型、抗生素选择、并发症、实验室数据、超声心动图数据和死亡率。结果 我们共发现60例确诊为IE的成年患者：其中55%为男性，平均年龄为48.71±18.3岁。高血压是最常见的合并症，影响23例患者（38.3%），其次是终末期肾病（ESRD）20例（33.3%）和糖尿病17例（28.3%）。 是最常见的病原体（25%），万古霉素是最常用的抗生素。58例患者接受了药物治疗（96.5%）。此外，88%的患者通过超声心动图检测到赘生物，大多数患者为单瓣膜受累。脓毒症是最常见的并发症，死亡率为36.7%。结论 在我们机构17年的时间里确诊的IE病例数量较少。令人惊讶的是，与文献相比，我们的患者死亡率较高，手术干预率较低。尽管我们承认回顾性病历审查研究存在局限性，但我们可以推测高死亡率可能部分与毒性较强的病原体数量较多、就诊延迟以及缺乏及时的手术干预有关。
