General features and short and long-term results of infective endocarditisin non-drug addicts

Introduction and objectives. Infective endocarditis is a disease with a hig h morbimortality during the active phase and a considerable risk of complic ations during follow-up. The aim of our study is to describe the clinical a nd prognostic features of infective endocarditis in nondrug addict patients in short and long terms. Patients and methods. A prospective study of 138 cases of infective endocar ditis in non-drug addict patients through the parenteral pathway treated in our institution from 1987 to 1997. Results. The mean age was 44 +/- 20 years. Ninety-five patients (69%) had n ative valve infective endocarditis and forty-three (31%) had prosthetic val ve endocarditis. Streptococci were the causal microorganism in 34% and Stap hylococci in 33%. 83% of patients developed some type of complications duri ng hospital stay. 51% of patients were operated on during the active phase (22% were urgent). The in-hospital mortality rate was 21%. 10 patients (9%) needed late cardiac surgery and seven patients (5%) died during follow-up. Global survival at 10 years was 71%. There were no statistical differences in survival in as much as the type of treatment received during the hospit al stay in the active phase (medical alone or combined medical-surgical). Conclusions. A high early surgery rate in the active phase related to good long-term results and does not increase early in-hospital mortality. Medica l treatment also offers good long-term results in cases of infectious endoc arditis with absense of bad prognostic factors and good clinical outcome.