@article{10902/35700,
year = {2024},
url = {https://hdl.handle.net/10902/35700},
abstract = {Background: Stroke is a common complication of infective endocarditis (IE). Our aim was to describe the prevalence and prognostic impact of stroke in a national cohort of IE.
Methods: Consecutive inclusion at 46 Spanish hospitals between 2008 and 2021.
Results: Out of 5667 IE cases, 1125 had acute stroke (19.8%): 818 ischemic strokes (811 cardioembolic strokes (193 with hemorrhagic transformation), 4 transient ischemic attacks, 3 lacunar infarctions), 127 intracranial hemorrhages, and 27 other neurological complications (cerebral abscesses, encephalitis, and meningitis). Compared to patients without stroke, those with stroke had a similar mean age (69 years) but were more frequently female (68.2% vs 63.7%, p = 0.04) and had a higher incidence of intracardiac complications (35% vs 30%, p = 0.01), surgical indication (69.9% vs 65.9%, p = 0.001), in-hospital mortality (40.9% vs 22.0%, p < 0.001), and 1-year mortality (46.2% vs 27.9%, p < 0.001). The following variables were independently associated with stroke: mitral location (odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.34-1.8, p < 0.001), vascular phenomenon (OR = 2.9, 95% CI = 2.4-3.6, p = 0.0001), acute renal failure (OR = 1.2, 95% CI = 1.0-1.4, p = 0.021), septic shock (OR = 1.3, 95% CI = 1.1-1.6, p = 0.007), sepsis (OR = 1.3, 95% CI = 1.1-1.6, p = 0.005), surgery indicated but not performed (OR = 1.4, 95% CI = 1.2-1.7, p < 0.001), community-acquired IE (OR = 1.2, 95% CI = 1-1.4, p = 0.017), and peripheral embolization (OR = 1.6, 95% CI = 1.4-1.9, p < 0.001). Stroke was an independent predictor of in-hospital (OR = 2.1, 95% CI = 1.78-2.51, p < 0.001) and 1-year mortality (hazard ratio = 1.9, 95% CI = 1.6-2.5).
Conclusion: One-fifth of patients with IE have concomitant stroke. Stroke is associated with mortality.},
publisher = {SAGE Publications},
publisher = {International journal of stroke : official journal of the International Stroke Society, 2024, 19(9), 989-998},
title = {Prevalence and prognostic impact of stroke in a national cohort of infective endocarditis},
author = {Álvarez Zaballos, Sara and Vázquez Alen, Pilar and Muñoz, Patricia and Alarcón González, Arístides de and Gutiérrez Carretero, Encarnación and Álvarez Uría, Ana and Fariñas Álvarez, María del Carmen and Rodríguez García, Raquel and Goenaga, Miguel Ángel and Cuervo, Guillermo and Plata Ciezar, Antonio and Hidalgo Tenorio, Carmen and Aldamiz Echevarría, Gonzalo and Martínez Sellés, Manuel},
}