P820Neurologic complications in infective endocarditis


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Abstract

Neurologic manifestations in patients with infective endocarditis have a reported incidence of about 20-40%. The clinical spectrum is wide and the fundamental mechanism implicated is emboligen, conferring an increase in mortality rates. Nevertheless, in cases with surgical indication it is unclear whether there are any contraindications or the optimal timing to perform it.Objectives: To determine the profile of patients who suffered neurological complications on the course of an infective endocarditis (IE), the predisposing factors and the prognosis.Methods: prospective observational study. 244 patients were admitted in our center with IE (following modified Duke criteria), from January 2003 to December 2010.Results: 40 Patients (16%) suffered neurological complications, 21 (52%) of which were ischemic events. Most of them were men (63%), with a mean age of 62±15 years. Mainly involved valves were left native, mostly aortic (52%). 29 of the patients (79%) had surgical indication of which 17 (42%) actually underwent surgery during the active phase, with a mean delay of 13±11 days from the diagnostic time. In-hospital mortality was high (42%), although there werent statistical differences when compared to the group without neurological complications. We didn't find significant differences when comparing etiology, vegetation size or valve involvement.Conclusions: In our series 16% of patients with IE suffered some kind of neurological complication, mostly ischemic events of embolic etiology. In-hospital death was elevated and so was the rate of surgical patients. Mean time to surgery, despite complications, was relatively short, with a low operative mortality rate.

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