Clinical Profile and Outcome of Infective Endocarditis in a Tertiary Care Centre: Retrospective Study

Abstract

Objective: This study was conducted to outline the clinical profile and outcomes of infective endocarditic (IE). It provides a contemporary picture of the presentation, etiology and outcomes of IE. Methods: A total of 97 consecutive cases of definitive IE who met the modified Duke's definitive criteria were included in the study. We analysed their clinic-epidemiologic features and outcomes. Results: The mean age was 34.8±14.6 years with male preponderance (57.7%). Rheumatic heart disease (RHD) (29.8%) was the commonest underlying cause followed by congenital heart disease (CHD) (20.6%). Fever as the main clinical feature was seen in 95.8%. About 61.8% of patients were in New York Heart Association (NYHA) class II. Blood culture was positive in 44.3% with commonest organisms being Staphylococcus aureus (10.3%) and Streptococci viridians (9.3%). Most common valve involvement was mitral valve (50.5%) followed by aortic valve (38.14%). Eleven (11.33%) patients had right-sided cardiac valve involvement. Complications were cardiovascular in 27 (27.8%) cases congestive heart failure in 24.7%, atrioventricular block in (3.1%), renal failure in 5 cases (5.2%) and neurological in 10 (10.30%) cases. In-hospital mortality was high (34.1%). Only 17 (17.5%) patients underwent surgery for IE. Conclusion: Morbidity as well as mortality is considerably high with IE. Staphylococcal infection is the most common etiologic agent. RHD is the commonest underlying heart disease in our population. Culture positivity rates and surgery for infective endocarditis is low. Early cardiac surgery may help to improve the outcomes in these patients.