Analysis of mortality and risk factors associated with native valve endocarditis in drug users: the importance of vegetation size

摘要: Background Native valve endocarditis in drug-user patients had a microbiology, frequency of involvement different cardiac valves, and prognosis that differ from those non–drug users. A retrospective study native cases intravenous drug users diagnosed 1985 to 1999 our institution was performed analyze the inhospital mortality with identify factors predictive mortality. Methods All fulfilled Duke's criteria for definite or probable endocarditis. Analysis predictors restricted right-sided infective (IE) diagnosis echocardiographic data. The following variables were analyzed: sex, HIV serostatus, CD4 cell count 3 , time IE (before 1993 after 1993), previous valvulopathy, polymicrobial IE, fungal etiology (mixed alone), neurological complication, arterial emboli, pulmonary congestive heart failure, vegetation size (VS) >2 cm, surgery. Logistic regression used multivariate model independently associated Adjusted odds ratios (OR) 95% CIs examined. Results Four hundred ninety-three this period. Two twenty identified. Fourteen group died (6%). Mean death 18.5 ± 15 days (range, 3-52). Vegetation available 111 cases. Univariate analysis identified cases: VS cm etiology. In analysis, achieved statistical significance ( P = .014, OR 10.2, CI 1.6-78.0) .009, 46.2, 2.4-1100.9). Conclusions main prognostic series role early surgery these should be reevaluated.