Lepur, Dragan and Baršić, Bruno
Incidence of neurological complications in patients with native-valve infective endocarditis and cerebral microembolism: an open cohort study.
Scandinavian Journal of Infectious Diseases, 41 (10).
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.
||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
||Katedra za infektologiju
||19 Nov 2010
||23 Sep 2011 16:11
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