Infective Endocarditis Patients Requiring ICU Admission

A study has demonstrated that while the prognosis for patients with infective endocarditis requiring admission to a hospital intensive care unit (ICU) is very serious, surgical intervention may be helpful in quite a few patients, even those with severe shock or multiorgan failure. The research, conducted by doctors at the University of Vienna (Austria), was reported in Critical Care (2002;6:149-154; www.ccforum.com).

The retrospective multicenter study involved 4,106 patients admitted to ICUs in 1994-1999. Doctors identified infective endocarditis in 33 (0.8%) patients. The reasons given for ICU transfer were congestive heart failure (64%), septic shock (21%), neurologic deterioration (15%), and cardiopulmonary resuscitation (9%). Inotropes or vasoconstrictors were needed in 73%, and 64% developed multiorgan failure.

Surgical intervention was performed in 60% of patients, while the remaining 40% were treated medically. In-patient mortality was 35% in the surgically treated patients but 84% in patients treated medically. Using multivariate analysis, the researchers found that acute renal failure on admission was identified as the independent single predictor for in-patient death.




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