Short- and long-term outcomes in infective endocarditis patients: a systematic review and meta-analysis

BMC Cardiovascular Disorders - Tập 17 - Trang 1-12 - 2017
Tadesse Melaku Abegaz1, Akshaya Srikanth Bhagavathula1, Eyob Alemayehu Gebreyohannes1, Alemayehu B. Mekonnen2, Tamrat Befekadu Abebe1,3
1Department of Clinical pharmacy, School of Phamacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
2Medication Safety Chair, College of Pharmacy, King Saud University, Riadh, Saudi Arabia
3Master’s Program in Health Economics, Policy and Managment; Student; Department of Learning, Informatics, Managent and Ethics, Karolinska Institutet, Solna, Sweden

Tóm tắt

Despite advances in medical knowledge, technology and antimicrobial therapy, infective endocarditis (IE) is still associated with devastating outcomes. No reviews have yet assessed the outcomes of IE patients undergoing short- and long-term outcome evaluation, such as all-cause mortality and IE-related complications. We conducted a systematic review and meta-analysis to examine the short- and long-term mortality, as well as IE-related complications in patients with definite IE. A computerized systematic literature search was carried out in PubMed, Scopus and Google Scholar from 2000 to August, 2016. Included studies were published studies in English that assessed short-and long-term mortality for adult IE patients. Pooled estimations with 95% confidence interval (CI) were calculated with DerSimonian-Laird (DL) random-effects model. Sensitivity and subgroup analyses were also performed. Publication bias was evaluated using inspection of funnel plots and statistical tests. Twenty five observational studies (retrospective, 14; prospective, 11) including 22,382 patients were identified. The overall pooled mortality estimates for IE patients who underwent short- and long-term follow-up were 20% (95% CI: 18.0–23.0, P < 0.01) and 37% (95% CI: 27.0–48.0, P < 0.01), respectively. The pooled prevalence of cardiac complications in patients with IE was found to be 39% (95%CI: 32.0–46.0) while septic embolism and renal complications accounted for 25% (95% CI: 20.0–31) and 19% (95% CI: 14.0–25.0) (all P < 0.01), respectively. Irrespective of the follow-up period, a significantly higher mortality rate was reported in IE patients, and the burden of IE-related complications were immense. Further research is needed to assess the determinants of overall mortality in IE patients, as well as well-designed observational studies to conform our results.

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