Data/hora: 08/06/2024 09:57:53

Provedor de dados: | 55
País: | Brazil
Título: | Asymptomatic and symptomatic embolic events in infective endocarditis: associated factors and clinical impact
Autores: | Monteiro,Thaíssa S.; Correia,Marcelo G.; Golebiovski,Wilma F.; Barbosa,Giovanna Ianini F.; Weksler,Clara; Lamas,Cristiane C.
Data: | 2017-06-01
Ano: | 2017
Palavras-chave: | Infective endocarditis; Embolism; Asymptomatic embolism; Splenomegaly; Cardiac surgery; Splenectomy.
Resumo: | ABSTRACT  Background: Embolic complications of infective endocarditis are common. The impact of asymptomatic embolism is uncertain.  Objectives: To determine the frequency of emboli due to IE and to identify events associated with embolism.  Methods: Retrospective analysis of an endocarditis database, prospectively implemented, with a post hoc study driven by analysis of data on embolic events. Data was obtained from the International Collaboration Endocarditis case report forms and additional information on embolic events and imaging reports were obtained from the medical records. Variables associated with embolism were analyzed by the statistical software R version 3.1.0.  Results: In the study period, 2006-2011, 136 episodes of definite infective endocarditis were included. The most common complication was heart failure (55.1%), followed by embolism (50%). Among the 100 medical records analyzed for emboli in left-sided infective endocarditis, 36 (36%) were found to have had asymptomatic events, 11 (11%) to the central nervous system and 28 (28%) to the spleen. Cardiac surgery was performed in 98/136 (72%). In the multivariate analysis, splenomegaly was the only associated factor for embolism to any site (p &lt; 0.01, OR 4.7, 95% CI 2.04-11). Factors associated with embolism to the spleen were positive blood cultures (p = 0.05, OR 8.9, 95% CI 1.45-177) and splenomegaly (p &lt; 0.01, OR 9.28, 95% CI 3.32-29); those associated to the central nervous system were infective endocarditis of the mitral valve (p &lt; 0.05, OR 3.5, 95% CI 1.23-10) and male gender (p &lt; 0.05, OR 3.2, 95% CI 1.04-10). Splenectomy and cardiac surgery did not impact on in-hospital mortality.  Conclusions: Asymptomatic embolism to the central nervous system and to the spleen were frequent. Splenomegaly was consistently associated with embolic events.
Tipo: | Info:eu-repo/semantics/article
Idioma: | Inglês
Identificador: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702017000300240
Editor: | Brazilian Society of Infectious Diseases
Relação: | 10.1016/j.bjid.2017.01.006
Formato: | text/html
Fonte: | Brazilian Journal of Infectious Diseases  v.21 n.3 2017
Fonte: | info:eu-repo/semantics/openAccess