Evaluation of relationship between clinical, paraclinical characteristics and treatment outcomes in patients with infective endocarditis at Ha Noi Heart Hospital

Abstract

Background: Globally, infective endocarditis (IE) patients exhibit a positive blood culture rate of 80-90%, while in Vietnam, this rate is lower at 68-70%. Hanoi Heart Hospital lacks previous evaluations of microbiological outcomes and their correlation with IE treatment. Objective: “Survey of clinical and paraclinical characteristics, microbiological results and treatment outcomes; relationship with clinical outcomes in patients with infective endocarditis”. Methods: A prospective, descriptive, cross-sectional study with longitudinal follow-up was conducted on IE patients diagnosed using the modified Duke criteria between May 2022 and October 2023. Results: Among 63 patients (mean age: 51.03 ± 15.92 years), 63.5% had NYHA class 2, and 93.7% had echocardiographic vegetations. Positive blood cultures were found in 36.5%, with Streptococcus, Staphylococcus, and Enterococcus faecalis being the predominant pathogens. Treatment included medical therapy (31.7%), emergency surgery (7.9%), and scheduled surgery (60.3%). Recurrence occurred in 12.7%, and mortality was 9.5%; C-reactive protein (CRP) was significantly associated with clinical outcomes (OR: 1.017, p = 0.003); AUC = 0.731 of negative blood cultures on admission to clinical outcomes. Conclusion: Transthoracic echocardiography effectively detects vegetations, and while positive blood culture rates are lower, overall outcomes are favorable. Elevated CRP and negative blood cultures at admission are significant predictors of clinical outcomes in IE patients.