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Prognostic implications of a negative echocardiography in patients with infective endocarditis

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dc.contributor.author Vicent, Lourdes
dc.contributor.author González Saldivar, Hugo
dc.contributor.author Bouza, Emilio
dc.contributor.author Muñoz, Patricia
dc.contributor.author Cuerpo, Gregorio
dc.contributor.author Alarcón González, Arístides de
dc.contributor.author Vidal, Bárbara
dc.contributor.author Cobo, Manuel
dc.contributor.author Goenaga, Miguel Ángel
dc.contributor.author Martínez Sellés Oliveria Soares, Manuel
dc.contributor.author Et al.
dc.date.accessioned 2018-06-08T07:56:43Z
dc.date.available 2018-06-08T07:56:43Z
dc.date.issued 2018
dc.identifier.citation Vicent, L., Saldivar, H. G., Bouza, E., Muñoz, P., Cuerpo, G., de Alarcón, A., ... & Martínez-Sellés, M. (2018). Prognostic implications of a negative echocardiography in patients with infective endocarditis. European Journal of Internal Medicine, 52, 40-48 . DOI: 10.1016/j.ejim.2018.01.033 spa
dc.identifier.issn 0953-6205
dc.identifier.uri http://hdl.handle.net/11268/7291
dc.description.abstract Background: Echocardiography plays an important role in infective endocarditis (IE) diagnosis according with the modified Duke criteria. We evaluated the implications of a positive echocardiography in the prognosis of a cohort of patients with IE. Methods: Prospective multicentre study in 31 Spanish centres. From January 2008 to September 2016, 3467 patients were included (2765 definite IE, 702 possible IE). The main outcome was in-hospital mortality. Echocardiography diagnosis was based on modified Duke criteria for the diagnosis of IE. Results: Median age was 69 years (interquartile range: 57–77 years). Comorbidity was high (mean Charlson index 4.7 ± 2.8). Transoesophageal echocardiography was performed in 2680 (77.3%). The overall inhospital mortality rate was 26.7%. Univariate analysis showed that, in patients with definite IE, inhospital mortality was similar in patients with positive and negative echocardiography (27.7% vs. 24.6%, respectively, p = 0.121). In possible IE these figures were 27.5% vs. 16.7%, respectively, p < 0.001. Complications (cardiac and extracardiac [embolic, immunological, and septic shock]) were more frequent with positive than with negative echocardiography, regardless of clinical suspicion (definite IE 35.5% vs. 16.8%, respectively, p < 0.001; possible IE 20.8% vs. 7.6%, respectively, p < 0.001). Positive echocardiography was a predictor of inhospital death by logistic regression modelling, after adjusting for confounders, definite IE (odds ratio [OR] 1.3, 95% confidence interval [CI] 1.02–1.76, p = 0.036), possible IE (OR 1.59, 95% CI 1.02–2.45, p = 0.036). Conclusions: A positive echocardiography in patients with IE is associated with increased inhospital mortality, in addition to other clinical factors and comorbidities. spa
dc.description.sponsorship SIN FINANCIACIÓN spa
dc.language.iso eng spa
dc.title Prognostic implications of a negative echocardiography in patients with infective endocarditis spa
dc.type article spa
dc.description.impact 3.282 JCR (2017) Q1, 27/154 Medicine, General and Internal spa
dc.identifier.doi 10.1016/j.ejim.2018.01.033
dc.rights.accessRights closedAccess spa
dc.subject.uem Endocarditis infecciosa spa
dc.subject.uem Ecocardiografía spa
dc.subject.unesco Enfermedad cardiovascular spa
dc.subject.unesco Tecnología médica spa
dc.description.filiation UEM spa
dc.peerreviewed Si spa


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