Key result
Cerebrovascular events in patients with infective endocarditis presented as multiple infarcts predominantly in the anterior circulation, resulting in high morbidity including a 68.7% rate of ICU admission and 12.5% mortality.
Why the study?
Patients with infective endocarditis can present with multiple neurological manifestations, and multiple factors predispose to cerebrovascular events and increased mortality.
Observational (n=16)
No
Cerebrovascular events occur in approximately 10% of patients with infective endocarditis and are associated with significantly increased morbidity and mortality.
Patients with infective endocarditis can have multiple neurological manifestations. Cerebrovascular events (CVE) in patients with IE can be hemorrhagic or embolic. Multiple factors are known to predispose to CVE and increased mortality in patients with IE. In this study, we aimed to describe various outcomes among patients with IE and CVE. We retrospectively analyzed 160 patients with definite IE. Among these, patients with radiological evidence of CVE were included. Clinical, radiological, echocardiographic details were obtained. Outcome studied were the requirement of intensive care unit care, the requirement of mechanical ventilation, prolonged course of antibiotics, prolonged duration of hospital stay, the requirement of surgical intervention, and mortality. In this study, 16 [10%] of patients with IE were identified to have a CVE. The mean age of the patients was 55, and 87.5% of them were male. 25% of patients had prior IE. IE involving left-sided valves were predominant, with the involvement of mitral valve reported in 62.5% of patients. More than half of the patient's had details of magnetic resonance imaging (MRI) of the brain. CVE were mostly ischemic, anterior circulation predominant, multiple, and bilateral. In patients with IE and CVE morbidity including the requirement of ICU care, prolonged antibiotics course, and the requirement of surgical intervention contributed to increased duration of hospital stay. In conclusion, CVE in patients with IE tends to present as multiple infarcts predominantly located over anterior circulation. IE patients with CVE tend to have higher morbidity and mortality.
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Mishra et al. (2022) conducted an observational in Infective endocarditis with cerebrovascular injury (n=16). Cerebrovascular events in infective endocarditis was evaluated on Morbidity and mortality outcomes including ICU admission, mechanical ventilation, surgical intervention, and death. Cerebrovascular events in patients with infective endocarditis presented as multiple infarcts predominantly in the anterior circulation, resulting in high morbidity including a 68.7% rate of ICU admission and 12.5% mortality.
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