Infective endocarditis in patients with oncological diseases

Enferm Infecc Microbiol Clin (Engl Ed). 2018 Feb;36(2):72-77. doi: 10.1016/j.eimc.2016.10.011. Epub 2016 Dec 13.
[Article in English, Spanish]

Abstract

Introduction: Cancer patients may constitute a special risk group for the development of infective endocarditis (IE) because they are often subjected to invasive procedures. The aim of this study is to determine the differential clinical profile and prognosis of patients with IE and cancer.

Methods: A retrospective observational study was conducted on all patients consecutively diagnosed with IE in a single centre between 2005 and 2015. A comparative analysis was performed between patients with cancer and those free of disease, as well as a long-term follow-up.

Results: There were 208 IE cases, of which 32 had a cancer diagnosis. There were no significant differences in age (67.5 [59.2-74] vs. 64 [51-74] years). The Charlson comorbidity index was same whether cancer was diagnosed or not (4 [2.2-5] vs. 3.9 [2-5]). IE in cancer patients was mainly associated with health care (59.5% vs 24.4%, P<.001). Staphylococcus aureus was the main causative agent (35%), and the tricuspid location was three times more common (18.8% vs. 6.2%). Surgery was not performed in 18.7% of patients, despite having an indication, compared with 7.4% of patients without cancer. In-hospital mortality for cancer patients was 45.5%, and the probability of survival at one year was 40%.

Conclusions: IE in patients with cancer is predominantly caused by staphylococci, and has high early mortality. Although it is often related to health care, patients are limited from the therapeutic point of view.

Keywords: Cancer; Cáncer; Endocarditis infecciosa; Infección nosocomial; Infective endocarditis; Nosocomial infection.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Comorbidity
  • Cross Infection / epidemiology
  • Cross Infection / therapy
  • Endocarditis / epidemiology*
  • Endocarditis / therapy
  • Follow-Up Studies
  • Hospital Mortality
  • Hospitals, University / statistics & numerical data
  • Humans
  • Kaplan-Meier Estimate
  • Middle Aged
  • Neoplasms / epidemiology*
  • Retrospective Studies
  • Spain / epidemiology
  • Staphylococcal Infections / epidemiology
  • Streptococcal Infections / epidemiology
  • Survival Rate
  • Treatment Outcome