| Title |
Infective endocarditis requiring ICU admission: epidemiology and prognosis
|
|---|---|
| Published in |
Annals of Intensive Care, December 2015
|
| DOI | 10.1186/s13613-015-0091-7 |
| Pubmed ID | |
| Authors |
Olivier Leroy, Hugues Georges, Patrick Devos, Steve Bitton, Nathalie De Sa, Céline Dedrie, Sébastien Beague, Pierre Ducq, Claire Boulle-Geronimi, Damien Thellier, Fabienne Saulnier, Sebastien Preau |
| Abstract |
Very few studies focused on patients with severe infective endocarditis (IE) and multiple complications leading to Intensive Care Unit (ICU) admission. Studied primary outcomes depended on the series and multiple prognostic factors have been identified. Our goal was to determinate characteristics of patients, in-hospital mortality and independent prognostic factors in an overall population of patients admitted to ICU for a left-sided, definite, active and severe IE. Retrospective study performed in 9 ICUs during an 11-year period. Data of 248 patients (mean age = 62.4 ± 13.3 years; 63.7 % male) were studied. Native and prosthetic valves were involved in 195 and 53 patients, respectively. Causative pathogens, identified in 225 patients, were mainly streptococci (45.6 %) and staphylococci (43.4 %). On ICU admission, 127 patients exhibited extra-cardiac involvement. Ninety-five patients had one or more neurological complications, as followed: ischemic stroke (n = 66), cerebral hemorrhage (n = 31), meningitis (n = 16), brain abscess (n = 16), and intracranial mycotic aneurysm (n = 10). Criteria prompting to cardiac surgery appeared during ICU stay for 186 patients and between ICU and hospital discharges in 5 patients. Due to contra-indications, surgery required by IE was only performed during hospitalization in 125 patients. Moreover, surgery was considered adequate according to usual guidelines in 76 of 191 patients with indication(s) of valvular surgery: for patients with surgical procedure considered as emergency (n = 69), 17 surgical procedures underwent within the first 24 h following indication; for patients with urgent surgical indication (n = 102), surgery was performed during the first week following indication in 40 patients; finally, elective surgery (n = 20) was performed for 19 patients. During hospitalization, 103 (41.5 %) patients died. Four independent prognostic factors were identified: SAPS II > 35 (AOR = 2.604; 95 % CI: 1.320-5.136; p = 0.0058), SOFA > 8 (AOR = 3.327; 95 % CI: 1.697-6.521; p = 0.0005), IE due to methicillin resistant Staphylococcus aureus (AOR = 4.981; 95 %CI = 1.433-17.306; p = 0.0115) and native IE (AOR = 0.345; 95 % CI: 0.169-0.703; p = 0.0034). Mortality in patients admitted to ICU for left-sided IE remains high, especially in cases of endocarditis due to methicillin resistant Staphylococcus aureus, when organ failures occur and ICU scores are high. |
Mendeley readers
The data shown below were compiled from readership statistics for 65 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Mexico | 1 | 2% |
| Unknown | 64 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 12 | 18% |
| Student > Postgraduate | 9 | 14% |
| Student > Bachelor | 8 | 12% |
| Student > Doctoral Student | 5 | 8% |
| Student > Ph. D. Student | 5 | 8% |
| Other | 13 | 20% |
| Unknown | 13 | 20% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 44 | 68% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Engineering | 2 | 3% |
| Agricultural and Biological Sciences | 1 | 2% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
| Other | 0 | 0% |
| Unknown | 15 | 23% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 December 2015.
All research outputs
#20,297,343
of 22,834,308 outputs
Outputs from Annals of Intensive Care
#956
of 1,043 outputs
Outputs of similar age
#324,860
of 387,568 outputs
Outputs of similar age from Annals of Intensive Care
#25
of 33 outputs
Altmetric has tracked 22,834,308 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,043 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.7. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 387,568 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 33 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.