Nihan KAHYA EREN, Kerem ÖZBEK, Fatih KAHRAMAN, Emin KALKAN, Serkan AKDAĞ, Mahmut AKPEK, Murat YÜKSEL, Mehmet Ali ELBEY, Abdulkadir YILDIZ, Mustafa OYLUMLU, Sinan DEMİRTAŞ, Selim TOPÇU, Mesut AYDIN

Enfektif endokardit tanısıyla ameliyat edilen hastaların demografik verileri ve sonuçları: Çok merkezli retrospektif çalışma

Amaç: Bu çalışmada Türkiye'de enfektif endokardit tanısıyla cerrahi tedavi uygulanan hastaların demografik ve klinik özellikleri ve ekokardiyografik ve mikrobiyolojik bulguları, yanı sıra ameliyat sonuçları araştırıldı.Çalışmaplanı:Bu çok merkezli çalışmaya Ocak 2005 - Ağustos 2012 tarihleri arasında 13 üçüncü basamak Üniversite/Eğitim ve Araştırma hastanesinde enfektif endokardit tanısıyla ameliyat edilen 116 hasta (65 erkek, 51 kadın; ort yaş 43±16 yıl; dağılım 14-80 yıl) alındı. Hastaların demografik ve klinik özellikleri, ekokardiyografik ve mikrobiyolojik bulguları, cerrahi tedavi endikasyonları ve ameliyat sonuçları retrospektif olarak incelendi.Bul gu lar: Hastaların en sık başvuru semptomu ve fizik muayene bulgusu ateş idi. Kan kültürü 35 hastada (%30) negatif idi. Stafilokoklar en sık saptanan mikrobiyolojik patojenlerdi (%22). Konjestif kalp yetmezliği 56 hastada (%48) en sık cerrahi endikasyon nedeni idi. On iki hastaya (%10) kapak tamir ameliyatı yapılırken, 104 hastada (%90) kapak replasmanı tercih edilen işlem oldu. Cerrahi tedavi uygulanan hastaların 33'ü ameliyat sonrası dönemde kaybedildi. Mortalite oranı (%28) idi. Cerrahi mortalitenin bağımsız öngördürücüleri Sınıf 3-4 fonksiyonel kapasite, C-reaktif protein yüksekliği ve böbrek fonksiyon bozukluğu olarak bulundu.So nuç: Enfektif endokardit komplike olgularda cerrahi olarak tedavi edilebilmesine rağmen, cerrahi tedavinin mortalite ve morbiditesi halen yüksektir

Demographical data and outcomes of surgically treated patients with the diagnosis of infective endocarditis: a multi-center retrospective study

Background: This study aims to investigate the demographic and clinical characteristics and echocardiographic and microbiological findings of the patients as well as the outcomes of surgery undergoing surgical treatment with the diagnosis of infective endocarditis in Turkey. Methods: Between January 2005 and August 2012 116 patients (65 males, 51 females; mean age 43±16 years; range 14 to 80 years) with the diagnosis of infective endocarditis who underwent surgery in 13 tertiary university/research and education hospitals were included in this multi-center study. Demographic and clinical characteristics of the patients, and echocardiographic and microbiological findings, surgical indications and outcomes of surgery were retrospectively analyzed. Results: The most common symptom on admission and physical finding was fever. Blood cultures were negative in 35 patients (30%). Staphylococci were the most common microbiological pathogens (22%). Congestive heart failure was the most common indication for surgery in 56 patients (48%). Valve repair was performed in 12 patients (10%), valve replacement was the procedure of choice in 104 patients (90%). Thirty-three patients undergoing surgical treatment died in the postoperative period. The mortality rate was 28%. Independent predictors of surgical mortality were Class 3-4 functional capacity, elevated C-reactive protein, and renal dysfunction. Conclusion: Although complicated cases of infective endocarditis can be treated through surgery, surgical morbidity and mortality is still high

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