Table 3.
Management and outcome data of patients with definite endocarditis according to management strategy
| Variable | Surgery (n=126) |
Medical therapy (n=45) |
Medical therapy (Surgical turndown) (n=14) |
||||||
| Pre-ET (n=74) |
Post-ET (n=63) |
P value | Pre-ET (n=21) |
Post-ET (n=24) |
P value | Pre-ET (n=6) |
Post-ET (n=8) |
P value | |
| Sequelae | |||||||||
| Immunological phenomena | 8 (10.8) | 9 (14.2) | 0.61 | 3 (14.3) | 1 (4.2) | 0.33 | 0 (0) | 1 (12.5) | 1.00 |
| Acute stroke | 17 (23.0) | 15 (23.8) | 1.00 | 4 (19.0) | 3 (12.5) | 0.69 | 1 (16.7) | 1 (12.5) | 1.00 |
| Other emboli | 28 (37.8) | 23 (36.5) | 1.00 | 8 (38.1) | 6 (25.0) | 0.52 | 2 (33.3) | 2 (25.0) | 1.00 |
| Congestive cardiac failure | 15 (20.3) | 12 (19.0) | 1.00 | 0 (0) | 1 (4.2) | 1.00 | 2 (33.3) | 2 (25.0) | 1.00 |
| Uncontrolled sepsis | 8 (10.8) | 17 (27.0) | 0.03 | 7 (33.3) | 5 (20.8) | 0.50 | 3 (50.0) | 5 (62.5) | 1.00 |
| Valvular abscess | 10 (13.5) | 10 (15.9) | 0.81 | 0 (0) | 0 (0) | – | 1 (16.7) | 3 (37.5) | 0.58 |
| Renal failure* | 8 (10.8) | 6 (9.5) | 1.00 | 2 (9.5) | 3 (12.5) | 1.00 | 1 (16.7) | 1 (12.5) | 1.00 |
| Investigations | |||||||||
| Time to first TTE (days) | 8.3±10.9 | 4.8±6.0 | 0.02 | 5.5±14.3 | 4.3±11.4 | 0.76 | 9.3±8.6 | 5.8±7.5 | 0.56 |
| Time to TOE following TTE (days) | 4.3±4.3 | 2.5±1.5 | 0.005 | 7.7±1.9 | 6.7±4.2 | 0.32 | 3.7±2.7 | 2.7±2.7 | 0.51 |
| Number of patients undergoing TOE | 52 (70.3) | 54 (85.7) | 0.04 | 12 (57.1) | 18 (75.0) | 0.23 | 5 (83.3) | 5 (62.5) | 0.58 |
| Management | |||||||||
| Time to IE-specific antibiotics† | 3.9±4.0 | 2.3±3.0 | 0.01 | 4.1±3.3 | 3.1±3.4 | 0.32 | 4.5±5.2 | 2.7±3.9 | 0.58 |
| Time to surgery† | 7.8±7.3 | 5.3±4.2 | 0.004 | – | – | – | – | – | |
| Duration of stay | 31.4±14.5 | 24.3±12.6 | 0.003 | 26.2±19.1 | 29.2±19.6 | 0.61 | 12.0±2.6 | 4.3±4.5 | 0.08 |
| Mortality | |||||||||
| In-hospital | 8 (11.4) | 6 (9.5) | 0.78 | 6 (28.6) | 2 (8.3) | 0.12 | 3 (50.0) | 4 (50.0) | 1.00 |
| 1 year | 14 (18.9) | 9 (14.3) | 0.51 | 12 (57.1) | 8 (33.3) | 0.03 | 5 (83.3) | 5 (62.5) | 0.96 |
Data shown as means±SD or number (percentage).
*Renal failure requiring renal replacement therapy.
†Number of days from suspected infective endocarditis.
ET, endocarditis team; IE, infective endocarditis; TOE, transoesophageal echocardiogram; TTE, transthoracic echocardiogram.