Effect of changes in diagnosis and management of active infective endocarditis on the clinical outcome at Srinagarind Hospital.

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dc.contributor.authorPachirat, Orathaien_US
dc.contributor.authorKiatchoosakun, Songsaken_US
dc.contributor.authorChetchotisakd, Ploenchanen_US
dc.contributor.authorTantisirin, Cherdchaien_US
dc.contributor.authorLimwattananon, Suponen_US
dc.contributor.authorLimwattananon, Julapornen_US
dc.date.accessioned2009-05-27T22:02:02Z
dc.date.available2009-05-27T22:02:02Z
dc.date.issued2005-04-09en_US
dc.descriptionChotmaihet Thangphaet.en_US
dc.description.abstractBACKGROUND: In recent years, diagnostic methods and treatment of infective endocarditis (IE) have been improved. It is not known whether the clinical outcome is any better. OBJECTIVE: To assess the effect of changes on the clinical outcomes of IE patients. MATERIAL AND METHOD: The authors performed a retrospective study comparing IE patients hospitalized at Srinagarind hospital during the period from 1/1/1990 to 31/12/2002. The authors classified the patients according to the period of diagnosed from 1990 to 1993 (n=57), 1994 to1997 (n=71), and 1998 to 2002 (n=72) cohorts. RESULTS: There were two hundred IE patients in the present study. Mean age and degenerative heart disease were increasing. Operative and in-hospital mortality were decreasing. Overall survival rate was 81% at the first year 60% at 5 years, 55% at 12 years in surgically treated patients, with 30-day mortality in 27.1% mostly from the 1990 to 1993 cohort. In medically treated IE, overall the survival rate was 37% in the first year, 32% at 5 years, 20% at 12 years, with 30-day mortality in 72.86% mostly in the 1990 to 1993 cohort. Early surgical intervention, improved long-term survival rates (hazard ratio 0.23; 95% CI 0.14-0.37), severe congestive heart failure (hazard ratio 1.87; 95% CI 1.17-2.99) and renal failure (hazard ratio 4.10; 95% CI 2.05-7.84) are the predictors of mortality by multivariate analysis. Survival rate from 1998 to 2002 cohort was 85%, 1994 to 1997 cohort was 54% and 1993 to 1990 cohort was 27% at 1-year (p < 0.001). CONCLUSION: The data indicated that the changing clinical outcome of this disease, reflected improvements in diagnostic method and treatment. Although IE remains a serious condition characterized by significant morbidity and mortality, the overall survival rate has significantly improved over time. The authors therefore, believe that early diagnosis and prompt treatment both medical or surgical interventions will improve the outcome of IE patients.en_US
dc.description.affiliationDepartment of Medicine, Khon Kaen University, Khon Kaen, Thailand.en_US
dc.identifier.citationPachirat O, Kiatchoosakun S, Chetchotisakd P, Tantisirin C, Limwattananon S, Limwattananon J. Effect of changes in diagnosis and management of active infective endocarditis on the clinical outcome at Srinagarind Hospital. Journal of the Medical Association of Thailand. 2005 Apr; 88(4): 498-504en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/45828
dc.language.isoengen_US
dc.source.urihttps://www.mat.or.th/journal/all.phpen_US
dc.subject.meshAcute Diseaseen_US
dc.subject.meshAgeden_US
dc.subject.meshAnti-Bacterial Agents --therapeutic useen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshEndocarditis, Bacterial --diagnosisen_US
dc.subject.meshFemaleen_US
dc.subject.meshHospitals, Universityen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshStaphylococcus aureus --drug effectsen_US
dc.subject.meshSurvival Rateen_US
dc.subject.meshThailand --epidemiologyen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshViridans Streptococci --drug effectsen_US
dc.titleEffect of changes in diagnosis and management of active infective endocarditis on the clinical outcome at Srinagarind Hospital.en_US
dc.typeJournal Articleen_US
dc.typeResearch Support, Non-U.S. Gov'ten_US
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