Right-sided infective endocarditis was associated with significantly lower in-hospital mortality (2.6%) compared to left-sided infective endocarditis (17%).
Cohort (n=215)
No
Does right-sided endocarditis have different clinical characteristics and prognosis compared to left-sided endocarditis in adult patients?
Right-sided infective endocarditis is associated with a younger demographic, higher rates of IV drug use and pacemaker infections, and significantly lower in-hospital mortality compared to left-sided endocarditis.
Absolute Event Rate: 2.6% vs 17%
p-value: p=0.037
OBJECTIVE: Right-sided endocarditis (RSE) accounts for 5%-10% of all cases of infective endocarditis (IE) and frequently has different etiological, pathogenetic, and clinical presentations compared with left-sided endocarditis (LSE). The aims of this study were to evaluate the epidemiologic and clinical characteristics and prognosis of RSE patients and to compare them with those of LSE patients. This study's importance relates to the local understanding of RSE and LSE, since Israeli demographics are different compared to the Unites States and Europe with regard to intravenous drug abuse and rheumatic valvular disease prevalence. MATERIAL AND METHODS: A retrospective cohort study of 215 patients with infective endocarditis was performed. The primary outcome was in-hospital mortality. The secondary outcomes were duration of hospitalization, recurrent hospitalization, recurrent infective endocarditis, and one-year mortality. RESULTS: Of the 215 patients in the study, 176 had LSE and 39 had RSE. The RSE patients were younger than the LSE patients (48.1±18.9 years versus 61.8±17.0 years, P<0.001). The most common pathogen in both groups was Staphylococcus aureus, which occurred more in the RSE group (51%) versus the LSE group (19%). In-hospital mortality was lower among patients with RSE (2.6% versus 17%, P<0.037). CONCLUSIONS: Our study demonstrated an increasing percentage of RSE compared to LSE among patients with IE. Pacemaker lead infection has become the leading cause of RSE in intravenous drug users (IVDU), although less common in Southern Israel. The etiological and clinical differences between RSE and LSE are noteworthy. Patients with RSE have a better prognosis than those with LSE.
Stavi et al. (Sun,) conducted a cohort in Infective endocarditis (n=215). Right-sided endocarditis vs. Left-sided endocarditis was evaluated on In-hospital mortality (p=0.037). Right-sided infective endocarditis was associated with significantly lower in-hospital mortality (2.6%) compared to left-sided infective endocarditis (17%).