Abstract 3039: Differences In Epidemiology And Prognosis From Infective Endocarditis Between Gender In A Tertiary-care Hospital.
Background: The aim of this study was to assess whether women with infectious endocarditis (IE) had a different clinical outcome than men.
Methods: Prospective observational cohort study in a single tertiary care institution. IE was diagnosed according to the modified Duke’s criteria.
Results: Between January and February 2007, 247 pts were diagnosed of IE. One hundred and sixty-six (67.2%) were men and 81 (32.8%) were women. Women were older than men (64.8±15 vs 57.3±16.9 y, p=0.001). Charlson’s index on admission was similar (1.82±2.23 vs 1.60±1.66, p=ns) but women were more frequently diabetic (13.4% vs 25.3%, p=0.019). There were no differences between sex regarding type of IE (prosthetic valve 20.9% in men vs 25.3% in women) or involved valve (men: 38.1% aortic valve (AV), 56.7% mitral valve (MV), 3.1% in two valves and 2.1% tricuspid valve (TV) vs women: 46.2% AV, 48.7% MV, 2.7% in two valves and 3.4% TV). Microbiology was similar. Presence of vegetations were more frequent in women than in men (95% vs 84.9%, p=0.018) but perianular complications were less frequent in women (32.8% vs 43%, p=0.039). There were no differences in cardiac heart failure (CHF) or acute renal failure (ARF), episodes of stroke or systemic embolism. However, women underwent less surgery (28.4% vs 49.1%, p=0.001) and died more than men during admission (39.5% vs 22.9%, p=0.006). Perioperative mortality showed a trend to be higher in women (25.1% vs 39.1% p=ns). Multivariable logistic regression showed as independents predictors associated in-hospital mortality: female sex (OR 2.66, 95% CI 1.08 – 6.52, p=0.033), stroke (OR 7.87, 95% CI 2.74 –22.62, p=0.0001), CHF (OR 6.97, 95% CI 2.70 –17.96, p=0.0001), ARF (OR 3.25, CI 1.27– 8.31, p=0.014). Women who died were more frequently older (69±11 vs 62±16, p=0.026) with a poor previous general condition (Charlson’s index 2.15±1.86 vs 1.22±1.41, p=0.026) and had major complications as CHF (75% vs 33.6%, p=0.0001), stroke and ARF (50% vs 16.7%, p=0.002).
Conclusions: Female patients with IE were older but showed a similar baseline clinical characteristics than men. However, they presented a number of major complications associated during admission period but underwent less surgery and had a worst outcome than men.