INFEKCIJSKI ENDOKARDITISI OD 1984. DO 2013.

Objective: To collect data on the clinical picture and all the predisposing factors that have been identified at the time of hospitalization in patients with IE who were hospitalized in the period from1984-2013, as well as to compare the adequacy of selected empirical antibiotic therapy according to the risk factors identifiedin the time of hospitalization. Methods: We retrospectively collected data on etiology, clinical presentation, complications and treatment of infective endocarditis in patients treated at the Clinic for Infectious Diseases, University Hospital Split in the period from 1984-2013. The study in cluded patients whose diagnosis of IE was set based on the Duke criteria. Patients with sterile blood culture and patients who were transferred to other departments with in the University Hospital Split were not included in examination of efficiency of empirical therapy. Statistical analysis was performed using χ²-testa Results: Higher incidence of acute forms of the disease, higher incidence in male patients and those older than 60 years of age were found. The most frequently identified pathogen was Staphylococcus aureus. The most frequent location of vegetations was left heart, with aortic valve most commonly involved. The main risk factor for the development of IE was age higher than 60 years. CNS is the most common seat of embolic events. Half of the patients with established etiology received appropriate empirical antimicrobial therapy on admission; a one third of them had a heart murmur. The most important cause of mortality in patients with IE is dysfunction of the heart valves .A small proportion of patients, 19%were treated with cardio surgery. Conclusion: The traditional differentiation between acute and subacute IE does not help in assessing the etiology of disease. Clinical feature of acute or subacute IE does not depend only on the causal bacteria, and majority of causative bacteria are able to cause both clinical presentations. The main predisposing factor for the development of IE was age, followed by known previous valvular heart disease. Presence of cardiac murmor on admission was the most important factor for early diagnosis of IE, and optimal choice of empirical antibiotic therapy. Most pathogens can cause both clinic presentation of IE.