Endocarditis infecciosa en la Unidad de Medicina Intensiva

objective: to study the characteristics, evolution and prognosis of patients with infectious endocarditis requiring treatment in the intensive care unit. design: a prospective, observational cohort study of patients admitted due to infectious endocarditis. setting: nuestra se？ora de candelaria university hospital, a third - level center with a recruitment population of 493,145. patients: all patients consecutively diagnosed with infectious endocarditis in our center according to the duke criteria, between 1 january 2005 and 31 july 2011. study variables: demographic data, clinical severity scores, microbiological and echocardiographic data, hospital mortality and complications. results: out of 102 patients diagnosed with endocarditis, 38 (37%) were admitted to intensive care. compared with those patients not admitted to the icu, these subjects suffered more frequent mitral valve alterations (or= 7.13; 95%ci: 2.12-24; p= 0.002) and cerebral embolism (or= 3.89; 95%ci: 1.06-14.3; p= 0.041). in turn, mortality was greater (42.1% vs 18.8%, p= 0.011), as was the proportion of emergency surgeries (45.8% vs 5.9%, p<0.001). the identified mortality predictors were staphylococcus aureus infection (or= 3.49; 95%ci 1.02-11.93; p=0.046), heart failure (or=4.18; 95%ci: 1.17-14.94; p=0.028), cerebral embolism (or= 8.45; 95%ci: 1.89-37.74; p=0.005) and the saps ii upon admission (or=1.09; 95%ci: 1.04-1.15; p<0.001). conclusions: a large proportion of patients with endocarditis require admission to the intensive care unit, presenting a much poorer prognosis. staphylococcus aureus infection, heart failure, cerebral embolism and saps ii scores are independent predictors of hospital mortality.