To assess clinical presentation, patient characteristics, causative microorganisms, treatment strategies, and all-cause mortality according to the interval between symptom onset and diagnosis of infective endocarditis (IE).
Approach:
Study Design: An observational cohort study using the National Danish Endocarditis Study (NIDUS) database, including all patients diagnosed with possible or definite IE in Denmark from January 1, 2016, to December 31, 2021.
Study Population: Included first hospitalization cases for IE, excluding patients with multiple episodes and those lacking symptom duration data. Patients were categorized based on symptom duration before diagnosis.
Clinical Characteristics and Treatment: Microbial aetiology was established through blood cultures. Surgical indications were based on the 2015 ESC guidelines.
Study Outcomes: Primary outcome was all-cause mortality at 6 months, with follow-up starting from diagnosis.
Key Findings:
Shorter prediagnostic symptom duration is associated with higher mortality.
Interpretation:
The findings may enhance understanding of the disease's natural course and facilitate timely diagnosis and treatment.
Limitations:
Exclusion of patients from other countries and those with incomplete symptom duration data.
Potential biases due to the observational nature of the study.
Conclusion:
The study highlights the importance of timely diagnosis in infective endocarditis and its impact on mortality.
by Mads-Gustav Nebel Hvidt, Amna Alhakak, Peter Laursen Graversen, Katra Hadji-Turdeghal, Jacob Eifer Møller, Niels Eske Bruun, Kasper Karmark Iversen, Jonas Agerlund Povlsen, Claus Moser, Morten Holdgaard Smerup, Daniel Faurholt-Jepsen, Henning Bundgaard, Lauge Østergaard, Lars Køber, Emil Loldrup Fosbøl
