Asymptomatic and symptomatic embolic events in infective endocarditis: associated factors and clinical impact

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dc.contributor.authorMonteiro, Thaíssa S.
dc.contributor.authorCorreia, Marcelo G.
dc.contributor.authorGolebiovski, Wilma F.
dc.contributor.authorBarbosa, Giovanna Ianini F.
dc.contributor.authorWeksler, Clara
dc.contributor.authorLamas, Cristiane C.
dc.date.accessioned2024-10-10T18:40:21Z
dc.date.available2024-10-10T18:40:21Z
dc.date.issued2017
dc.description.abstractBackground: Embolic complications of infective endocarditis are common. The impact of asymptomatic embolism is uncertain. Objectives: To determine the frequency of emboli due to IE and to identify events associated with embolism. Methods: Retrospective analysis of an endocarditis database, prospectively implemented, with a post hoc study driven by analysis of data on embolic events. Data was obtained from the International Collaboration Endocarditis case report forms and additional information on embolic events and imaging reports were obtained from the medical records. Variables associated with embolism were analyzed by the statistical software R version 3.1.0. Results: In the study period, 2006–2011, 136 episodes of definite infective endocarditis were included. The most common complication was heart failure (55.1%), followed by embolism (50%). Among the 100 medical records analyzed for emboli in left-sided infective endocardi- tis, 36 (36%) were found to have had asymptomatic events, 11 (11%) to the central nervous system and 28 (28%) to the spleen. Cardiac surgery was performed in 98/136 (72%). In the multivariate analysis, splenomegaly was the only associated factor for embolism to any site (p < 0.01, OR 4.7, 95% CI 2.04–11). Factors associated with embolism to the spleen were positive blood cultures (p = 0.05, OR 8.9, 95% CI 1.45–177) and splenomegaly (p < 0.01, OR 9.28, 95% CI 3.32–29); those associated to the central nervous system were infective endocarditis of the mitral valve (p < 0.05, OR 3.5, 95% CI 1.23–10) and male gender (p < 0.05, OR 3.2, 95% CI 1.04–10). Splenectomy and cardiac surgery did not impact on in-hospital mortality. Conclusions: Asymptomatic embolism to the central nervous system and to the spleen were frequent. Splenomegaly was consistently associated with embolic events.
dc.identifier.citationMonteiro TS, Correia MG, Golebiovski WF, Barbosa GIF, Weksler C, Lamas CC. Asymptomatic and symptomatic embolic events in infective endocarditis: associated factors and clinical impact. Braz J Infect Dis. 2017 May-Jun;21(3):240-247. doi: 10.1016/j.bjid.2017.01.006.
dc.identifier.otherDOI: 10.1016/j.bjid.2017.01.006
dc.identifier.urihttps://dspace.inc.saude.gov.br/handle/123456789/486
dc.language.isoen
dc.publisherBrazilian Journal of Infectious Diseases
dc.subjectInfective endocarditisen
dc.subjectEmbolismen
dc.subjectAsymptomatic embolismen
dc.subjectSplenomegalyen
dc.subjectCardiac surgeryen
dc.subjectSplenectomyen
dc.titleAsymptomatic and symptomatic embolic events in infective endocarditis: associated factors and clinical impact
dc.typeArticle
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