Incidence of neurological complications in patients with native-valve infective endocarditis and cerebral microembolism: an open cohort study

Scientific paper - Original scientific paper

• Author: Dragan Lepur
• Author: Bruno Baršić
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

The objective of this open cohort study was to assess the association between neurological complications in patients with definite native-valve infective endocarditis (IE) and cerebral microembolism (MES). MES detection was performed with 1-h, bilateral middle cerebral arteries (MCA) insonation using a transcranial Doppler ultrasound (TCD) machine. Thirty patients with definite native-valve IE were stratified into 2 groups based upon the presence of MES. The most striking difference between the 2 groups of patients was the incidence of clinically evident neurological complications. Neurological complications of IE occurred in 10 (83.3%) patients with positive MES and in 6 (33.3%) MES-negative patients (p=0.021). Ischaemic stroke was the most common complication, occurring in 11 of 16 patients, followed by meningitis in 4 patients and cerebritis in 1 patient. There was a trend towards greater in-hospital mortality in patients with recorded MES than in the MES-negative, although this was not statistically significant (33.3% vs 16.6%; p=0.392). Our results reveal a significant association between MES and neurological complications in patients with native-valve IE. TCD is a promising tool in predicting individual patient risk for neurological complications of IE.

• Keywords (english): Adult; Aged; Brain Abscess/etiology; Brain Abscess/ultrasonography; Brain Ischemia/etiology; Brain Ischemia/ultrasonography; Cerebral Hemorrhage/etiology; Cerebral Hemorrhage/ultrasonography; Chi-Square Distribution; Cohort Studies; Endocarditis/complications; Endocarditis/ultrasonography; Female; Humans; Intracranial Embolism/complications; Intracranial Embolism/ultrasonography; Male; Meningitis/etiology; Meningitis/ultrasonography; Middle Aged; Nervous System Diseases/etiology; Nervous System Diseases/ultrasonography; Prospective Studies; Ultrasonography, Doppler, Transcranial
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Accepted version
• Journal title: Scandinavian Journal of Infectious Diseases
• Numbering: vol. 41, no. 10, pp. 708-713
• p-ISSN: 0036-5548
• DOI: https://doi.org/10.1080/00365540903146995
• URN:NBN: urn:nbn:hr:105:935890
• Publication: 2009
• Document URL: https://doi.org/10.1080/00365540903146995
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 11:51:25