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    A multicenter study on experience of 13 tertiary hospitals in Turkey in patients with infective endocarditis
    (Turkish Soc Cardiology, 2013) Elbey, Mehmet Ali; Akdağ, Serkan; Kalkan, Mehmet Emin; Kaya, Mehmet G.; Sayın, Muhammet Raşit; Karapınar, Hekim; Akyüz, Abdurrahman
    Objective: The aim of this retrospective multicenter study was to investigate the clinical manifestations, microbiological profile, echocardiographic findings and management strategies of infective endocarditis (IE) in Turkey. Methods: The study population consisted of 248 Turkish patients with IE treated at 13 major hospitals in Turkey from 2005 to 2012 retrospectively. All hospitals are tertiary referral centers, which receive patients from surrounding hospitals. Data were collected from the medical files of all patients hospitalized with IE diagnosed according to modified Duke Criteria. Results: One hundred thirty seven of the patients were males. Native valves were involved in 158 patients while in 75 participants there was prosthetic valve endocarditis. Vegetations were detected in 223 patients (89%) and 52 patients had multiple vegetations. Mitral valve was the most common site of vegetation (43%). The most common valvular pathology was mitral regurgitation. The most common predisposing factor was rheumatic valvular disease (28%). Positive culture rate was 65%. Staphylococci were the most frequent causative microorganisms isolated (29%) followed by enterococci (11%). In-hospital mortality rate was 33%. Conclusions: Compared to IE in developed countries younger age, higher prevalence of rheumatic heart disease, more frequent enterococci infection and higher rates of culture negativity were other important aspects of IE epidemiology in Turkey.
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    PROGNOSTIC FACTORS AND IN-HOSPITAL OUTCOME OF NATIVE VALVE ENDOCARDITIS IN TURKEY. A MULTICENTER STUDY
    (Carbone Editore, 2014) Akıl, Mehmet Ata; Acet, Halit; Elbey, Mehmet Ali; Aydın, Mesut; Bilik, Zihni; Yıldız, Abdülkadir; Ülgen, Sıddık
    Aim: To investigate the predisposing factors, demographic and clinical characteristics, echocardiographic and prognostic features, and Outcomes of patients with native valve infective endocarditis (IE) in Turkey in a multicenter based study. Materials and methods: The study population consisted Of 15,8 consecutive patients with native valve IE (NVE). Data on demographics, medical history, medications, clinical procedures, predisposing factors, clinical examination, microbiology, antibiotic therapy, echocardiography, surgery, complications, and outcome were collected and compared. Results: The mean age of the patients was 47 19 (range 13-87). Seventy seven patients (49%) Were female. Of the 158. NVE patients, 49 died during hospitalization. Mortality rate was 31%. Twenty eight patients experienced a stroke. The patients who died during hospitalization were significantly older than the survivors and had higher mean heart rate, white blood cell, C reactive protein, creatinine, poor NYHA functional etas's, multiple vegetations and large vegetations. Culture negative endocarditis was seen in 54 eases (34%). Staphylococci were the most common causative organisms (28%). Eighty patients had undergone surgical treatment (51%). Hemoglobin, presence of multiple vegetation, vegetation size. (>10 mm), septic shock and poor NYHA Class on admission were independent risks for in hospital mortality and stroke Beside these variables C. reactive Protein was also an independent risk for in hospital mortality Conclusion: Native valve IE in Turkey was associated with high in hospital mortality. Rheumatic heart disease continues to be the most common underlying heart condition and echocardiographie findings on admission were the most important independent predictors of mortality or stroke.