RT Journal Article
T1 Contemporary epidemiology and prognosis of septic shock in infective endocarditis
A1 Olmos, Carmen
A1 Vilacosta, Isidre
A1 Fernández, Cristina
A1 Ferrera, Carlos
A1 Silva Guisasola, Jacobo Alberto
A1 Vivas Balcones, Luis David
A1 San Román, José Alberto
AB Aims: The prognosis of patients with infective endocarditis (IE) remains poor despite the great advances in the last decades. One of the factors closely related to mortality is the development of septic shock (SS). The aim of our study was to describe the profile of patients with IE complicated with SS, and to identify prognostic factors of new-onset SS during hospitalization.Methods and results: We conducted a prospective study including 894 episodes of IE diagnosed at three tertiary centres. A backward logistic regression analysis was undertaken to determine prognostic factors associated with SS development. Multivariable analysis identified the following as predictive of SS development: diabetes mellitus [odds ratio (OR) 2.06; confidence interval (CI) 1.16-3.68], Staphylococcus aureus infection (OR: 2.97; CI: 1.72-5.15), acute renal insufficiency (OR: 3.22; CI: 1.28-8.07), supraventricular tachycardia (OR: 3.29; CI: 1.14-9.44), vegetation size ≥15 mm (OR: 1.21; CI: 0.65-2.25), and signs of persistent infection (OR: 9.8; CI: 5.48-17.52). Risk of SS development could be stratified when combining the first five variables: one variable present: 3.8% (CI: 2-7%); two variables present: 6.3% (CI: 3.2-12.1%); three variables present: 14.6% (CI: 6.8-27.6%); four variables present: 29.1% (CI: 11.7-56.1%); and five variables present: 45.4% (95% CI: 17.5-76.6%). When adding signs of persistent infection, the risk dramatically increased, reaching 85.7% (95% CI: 61.2-95.9%) of risk.Conclusions: In patients with IE, the presence of diabetes, acute renal insufficiency, Staphylococcus aureus infection, supraventricular tachycardia, vegetation size ≥15 mm, and signs of persistent infection are associated with the development of SS.
PB Oxford University Press
SN 1522-9645
YR 2013
FD 2013-07-01
LK https://hdl.handle.net/20.500.14352/99895
UL https://hdl.handle.net/20.500.14352/99895
LA eng
NO Olmos C, Vilacosta I, Fernández C, López J, Sarriá C, Ferrera C, Revilla A, Silva J, Vivas D, González I, San Román JA. Contemporary epidemiology and prognosis of septic shock in infective endocarditis. Eur Heart J. 2013;34:1999-2006
DS Docta Complutense
RD 22 ago 2024