Impact of Neurological Complications on Long-Term Outcomes in Patients with Infective Endocarditis.
Pedro Henrique Oliveira Murta PintoIsabela Galizzi FaéGustavo Brandão OliveiraRoni Arley Silva DuqueMauricio Vitor Machado OliveiraLuan Salvador Machado BarbalhoAndré Oliveira ParreirasFernanda Alves GelapeFernanda Sophya Leite CambraiaGuilherme Lelis CostaLucas Chaves DiamanteRenato BráulioCláudio Léo GelapeAndréa Teixeira-CarvalhoTeresa Cristina Abreu FerrariMaria Carmo Pereira NunesPublished in: Tropical medicine and infectious disease (2024)
Neurological complications are frequent during the active course of infective endocarditis (IE), and they are associated with high in-hospital mortality rates. However, limited data exist on the prognostic value of these complications for late outcomes. This study aimed to assess the long-term impact of neurological complications in patients surviving an IE episode. A total of 263 consecutive IE patients admitted to a tertiary care center between 2007 and 2022 were prospectively included. Neurological complications at admission included transient ischemic attack (TIA), ischemic stroke, hemorrhagic stroke, intracerebral abscess, and meningitis. The primary outcome was a composite of overall mortality or heart valve surgery. Of the patients, 34.2% died in the hospital, leaving 173 survivors for long-term follow-up. Over a median of 3.5 years, 29 patients died, and 13 (9%) underwent cardiac surgery, resulting in an overall adverse event rate of 30%. Neurological complications independently predicted long-term adverse outcomes (hazard ratio (HR) 2.237; 95% CI 1.006-4.976), after adjusting for age, chronic kidney disease (CKD), and heart failure (HF) development. In an IE patient cohort, neurological complications at admission, which is a complication directly related to the IE process, were independent predictors of long-term outcomes.
Keyphrases
- end stage renal disease
- chronic kidney disease
- heart failure
- risk factors
- ejection fraction
- newly diagnosed
- cardiac surgery
- peritoneal dialysis
- cerebral ischemia
- healthcare
- tertiary care
- atrial fibrillation
- prognostic factors
- metabolic syndrome
- patient reported outcomes
- left ventricular
- young adults
- acute kidney injury
- cardiovascular disease
- blood brain barrier
- adipose tissue
- case report
- deep learning