Predictors of infective endocarditis associated in-hospital mortality in Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia: Microbiological,clinical features, and management profiles
Infective endocarditis (IE) is a continuously evolving disease with a high mortality rate despite different advances in treatment. In Ethiopia, there is a paucity of data regarding IE. Therefore, this study is aimed at assessing IE-related in-hospital mortality and characterization of IE patients ba...
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| Veröffentlicht in: | PloS one 2024-05, Vol.19 (5), p.e0300322-e0300322 |
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| creator | Tesfay, Hagazi Weldu, Yemane Ebrahim, Mohamedawel Mohamedniguss Hailu, Abraha Gidey, Kibreab Gebrehaweria, Teklay Berhane, Samuel Gessesse, Zekarias Kahsay, Hagos Mezmur, Daniel Fisseha, Kidan Haileselassie, Aregawi Bayray, Alemayehu |
| description | Infective endocarditis (IE) is a continuously evolving disease with a high mortality rate despite different advances in treatment. In Ethiopia, there is a paucity of data regarding IE. Therefore, this study is aimed at assessing IE-related in-hospital mortality and characterization of IE patients based on their microbiological, clinical features, and management profiles in the Ayder Comprehensive Specified Hospital (ACSH).
We conducted a hospital-based prospective follow-up study with all consecutive sampling techniques for suspected infective endocarditis patients admitted to ACSH from January 2020 to February 2022. Echocardiography was performed, and three sets of blood samples for blood culture were taken as per the standard protocol. We also performed isolation of microbial etiologies and antimicrobial susceptibility tests. The data was analyzed using STATA version 16. Stepwise logistic regression was run to identify predictors of in-hospital mortality. Effects were measured through the odds ratio at the 5% level of significance.
Seventy-four cases of suspected infective endocarditis were investigated; of these, 54 episodes fulfilled modified Duke's criteria. Rheumatic heart disease (RHD) (85.2%) was the most common underlying heart disease. Murmur (94.4%), fever (68.5%), and pallor (57.4%) were the most common clinical findings. Vegetation was present in 96.3% of episodes. Blood culture was positive only in 7 (13%) episodes. Complications occurred in 41 (75.9%) cases, with congestive heart failure being the most common. All patients were managed medically, with no surgical intervention. The in-hospital mortality was 14 (25.9%). IE-related in-hospital mortality was significantly associated with surgery recommendation and myalgia clinical symptoms.
IE occurred relatively in a younger population, with RHD as the most common underlying heart disease. There was a high rate of culture-negative endocarditis, and the majority of patients were treated empirically. Mortality was high. The establishment of cardiac surgery and strengthening microbiology services should be given top priority. |
| doi_str_mv | 10.1371/journal.pone.0300322 |
| format | Article |
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We conducted a hospital-based prospective follow-up study with all consecutive sampling techniques for suspected infective endocarditis patients admitted to ACSH from January 2020 to February 2022. Echocardiography was performed, and three sets of blood samples for blood culture were taken as per the standard protocol. We also performed isolation of microbial etiologies and antimicrobial susceptibility tests. The data was analyzed using STATA version 16. Stepwise logistic regression was run to identify predictors of in-hospital mortality. Effects were measured through the odds ratio at the 5% level of significance.
Seventy-four cases of suspected infective endocarditis were investigated; of these, 54 episodes fulfilled modified Duke's criteria. Rheumatic heart disease (RHD) (85.2%) was the most common underlying heart disease. Murmur (94.4%), fever (68.5%), and pallor (57.4%) were the most common clinical findings. Vegetation was present in 96.3% of episodes. Blood culture was positive only in 7 (13%) episodes. Complications occurred in 41 (75.9%) cases, with congestive heart failure being the most common. All patients were managed medically, with no surgical intervention. The in-hospital mortality was 14 (25.9%). IE-related in-hospital mortality was significantly associated with surgery recommendation and myalgia clinical symptoms.
IE occurred relatively in a younger population, with RHD as the most common underlying heart disease. There was a high rate of culture-negative endocarditis, and the majority of patients were treated empirically. Mortality was high. The establishment of cardiac surgery and strengthening microbiology services should be given top priority.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0300322</identifier><identifier>PMID: 38696370</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acids ; Adolescent ; Adult ; Aged ; Antibiotics ; Biology and Life Sciences ; Blood ; Blood culture ; Cardiology ; Cardiovascular disease ; Cardiovascular diseases ; Congestive heart failure ; Data collection ; Development and progression ; Echocardiography ; Endocarditis ; Endocarditis - diagnosis ; Endocarditis - microbiology ; Endocarditis - mortality ; Ethiopia ; Ethiopia - epidemiology ; Female ; Follow-Up Studies ; Heart diseases ; Heart failure ; Hospital Mortality ; Hospitals ; Hospitals, Special ; Humans ; Infective endocarditis ; Internal medicine ; Male ; Medical examination ; Medical research ; Medicine and Health Sciences ; Medicine, Experimental ; Metronidazole ; Microbiology ; Microorganisms ; Middle Aged ; Mortality ; Myalgia ; Patient outcomes ; Patients ; Penicillin ; People and Places ; Prospective Studies ; Rheumatic heart disease ; Risk Factors ; Sampling methods ; Sampling techniques ; Signs and symptoms ; Sub-Saharan Africa ; Surgery ; Variables ; Vegetation ; Young Adult</subject><ispartof>PloS one, 2024-05, Vol.19 (5), p.e0300322-e0300322</ispartof><rights>Copyright: © 2024 Tesfay et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Tesfay et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Tesfay et al 2024 Tesfay et al</rights><rights>2024 Tesfay et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c642t-70da2bd3bb7583f6249f68731cdb78032a10a2357e832b084467958463fb4c733</cites><orcidid>0000-0003-4556-2579 ; 0009-0001-2795-8046 ; 0000-0003-2664-0500</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11065255/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11065255/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,2106,2932,23875,27933,27934,53800,53802</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38696370$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Marino, Andrea</contributor><creatorcontrib>Tesfay, Hagazi</creatorcontrib><creatorcontrib>Weldu, Yemane</creatorcontrib><creatorcontrib>Ebrahim, Mohamedawel Mohamedniguss</creatorcontrib><creatorcontrib>Hailu, Abraha</creatorcontrib><creatorcontrib>Gidey, Kibreab</creatorcontrib><creatorcontrib>Gebrehaweria, Teklay</creatorcontrib><creatorcontrib>Berhane, Samuel</creatorcontrib><creatorcontrib>Gessesse, Zekarias</creatorcontrib><creatorcontrib>Kahsay, Hagos</creatorcontrib><creatorcontrib>Mezmur, Daniel</creatorcontrib><creatorcontrib>Fisseha, Kidan</creatorcontrib><creatorcontrib>Haileselassie, Aregawi</creatorcontrib><creatorcontrib>Bayray, Alemayehu</creatorcontrib><title>Predictors of infective endocarditis associated in-hospital mortality in Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia: Microbiological,clinical features, and management profiles</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Infective endocarditis (IE) is a continuously evolving disease with a high mortality rate despite different advances in treatment. In Ethiopia, there is a paucity of data regarding IE. Therefore, this study is aimed at assessing IE-related in-hospital mortality and characterization of IE patients based on their microbiological, clinical features, and management profiles in the Ayder Comprehensive Specified Hospital (ACSH).
We conducted a hospital-based prospective follow-up study with all consecutive sampling techniques for suspected infective endocarditis patients admitted to ACSH from January 2020 to February 2022. Echocardiography was performed, and three sets of blood samples for blood culture were taken as per the standard protocol. We also performed isolation of microbial etiologies and antimicrobial susceptibility tests. The data was analyzed using STATA version 16. Stepwise logistic regression was run to identify predictors of in-hospital mortality. Effects were measured through the odds ratio at the 5% level of significance.
Seventy-four cases of suspected infective endocarditis were investigated; of these, 54 episodes fulfilled modified Duke's criteria. Rheumatic heart disease (RHD) (85.2%) was the most common underlying heart disease. Murmur (94.4%), fever (68.5%), and pallor (57.4%) were the most common clinical findings. Vegetation was present in 96.3% of episodes. Blood culture was positive only in 7 (13%) episodes. Complications occurred in 41 (75.9%) cases, with congestive heart failure being the most common. All patients were managed medically, with no surgical intervention. The in-hospital mortality was 14 (25.9%). IE-related in-hospital mortality was significantly associated with surgery recommendation and myalgia clinical symptoms.
IE occurred relatively in a younger population, with RHD as the most common underlying heart disease. There was a high rate of culture-negative endocarditis, and the majority of patients were treated empirically. Mortality was high. The establishment of cardiac surgery and strengthening microbiology services should be given top priority.</description><subject>Acids</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Antibiotics</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Blood culture</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Congestive heart failure</subject><subject>Data collection</subject><subject>Development and progression</subject><subject>Echocardiography</subject><subject>Endocarditis</subject><subject>Endocarditis - diagnosis</subject><subject>Endocarditis - microbiology</subject><subject>Endocarditis - mortality</subject><subject>Ethiopia</subject><subject>Ethiopia - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Hospital 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tesfay, Hagazi</au><au>Weldu, Yemane</au><au>Ebrahim, Mohamedawel Mohamedniguss</au><au>Hailu, Abraha</au><au>Gidey, Kibreab</au><au>Gebrehaweria, Teklay</au><au>Berhane, Samuel</au><au>Gessesse, Zekarias</au><au>Kahsay, Hagos</au><au>Mezmur, Daniel</au><au>Fisseha, Kidan</au><au>Haileselassie, Aregawi</au><au>Bayray, Alemayehu</au><au>Marino, Andrea</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of infective endocarditis associated in-hospital mortality in Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia: Microbiological,clinical features, and management profiles</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-05-02</date><risdate>2024</risdate><volume>19</volume><issue>5</issue><spage>e0300322</spage><epage>e0300322</epage><pages>e0300322-e0300322</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Infective endocarditis (IE) is a continuously evolving disease with a high mortality rate despite different advances in treatment. In Ethiopia, there is a paucity of data regarding IE. Therefore, this study is aimed at assessing IE-related in-hospital mortality and characterization of IE patients based on their microbiological, clinical features, and management profiles in the Ayder Comprehensive Specified Hospital (ACSH).
We conducted a hospital-based prospective follow-up study with all consecutive sampling techniques for suspected infective endocarditis patients admitted to ACSH from January 2020 to February 2022. Echocardiography was performed, and three sets of blood samples for blood culture were taken as per the standard protocol. We also performed isolation of microbial etiologies and antimicrobial susceptibility tests. The data was analyzed using STATA version 16. Stepwise logistic regression was run to identify predictors of in-hospital mortality. Effects were measured through the odds ratio at the 5% level of significance.
Seventy-four cases of suspected infective endocarditis were investigated; of these, 54 episodes fulfilled modified Duke's criteria. Rheumatic heart disease (RHD) (85.2%) was the most common underlying heart disease. Murmur (94.4%), fever (68.5%), and pallor (57.4%) were the most common clinical findings. Vegetation was present in 96.3% of episodes. Blood culture was positive only in 7 (13%) episodes. Complications occurred in 41 (75.9%) cases, with congestive heart failure being the most common. All patients were managed medically, with no surgical intervention. The in-hospital mortality was 14 (25.9%). IE-related in-hospital mortality was significantly associated with surgery recommendation and myalgia clinical symptoms.
IE occurred relatively in a younger population, with RHD as the most common underlying heart disease. There was a high rate of culture-negative endocarditis, and the majority of patients were treated empirically. Mortality was high. The establishment of cardiac surgery and strengthening microbiology services should be given top priority.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>38696370</pmid><doi>10.1371/journal.pone.0300322</doi><orcidid>https://orcid.org/0000-0003-4556-2579</orcidid><orcidid>https://orcid.org/0009-0001-2795-8046</orcidid><orcidid>https://orcid.org/0000-0003-2664-0500</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2024-05, Vol.19 (5), p.e0300322-e0300322 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_3069285360 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acids Adolescent Adult Aged Antibiotics Biology and Life Sciences Blood Blood culture Cardiology Cardiovascular disease Cardiovascular diseases Congestive heart failure Data collection Development and progression Echocardiography Endocarditis Endocarditis - diagnosis Endocarditis - microbiology Endocarditis - mortality Ethiopia Ethiopia - epidemiology Female Follow-Up Studies Heart diseases Heart failure Hospital Mortality Hospitals Hospitals, Special Humans Infective endocarditis Internal medicine Male Medical examination Medical research Medicine and Health Sciences Medicine, Experimental Metronidazole Microbiology Microorganisms Middle Aged Mortality Myalgia Patient outcomes Patients Penicillin People and Places Prospective Studies Rheumatic heart disease Risk Factors Sampling methods Sampling techniques Signs and symptoms Sub-Saharan Africa Surgery Variables Vegetation Young Adult |
| title | Predictors of infective endocarditis associated in-hospital mortality in Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia: Microbiological,clinical features, and management profiles |
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