Endocarditis infecciosa en pacientes diabéticosun perfil diferente con consecuencias pronósticas

Abstract

Background. Infective Endocarditis (IE) is a severe condition. Diabetes mellitus (0M) has been associated with a poor prognosis in other pathologies. Our aim was to describe the clinical profile and the prognosis of IE with and without DM and to analyse the prognostic relevance of DM-related organ damage. Methods, Retrospective analysis of the Spanish IE Registry (2008-2020) that includes information from 38 hospitals. We used data from all consecutive patients who met the inclusion criteria diagnosis of definitive or probable IE according to the modified Duke criteria. Our only exclusion criteria was that information regarding DM wasn't collected. We performed multivariate logistic regression analysis (backwards conditional successive steps) to determine the predictors of mortality and to evaluate the independent association of the DM, with or without organ damage, with mortality. All the variables in the univariate analysis with were included. Results. Cohort composed by 5.590 IE patients, mean age 65.0 ±15.5 years, 3.764 (67,3%) were male. DM was found in 1.625 patients (29,1%) and 515 presented DM-related organ damage. DM prevalence during the first half of the study period was 27,6% vs. 30,6% in the last half, Patients with DM presented higher in-hospital mortality than those without DM (521 vs 924 p <O.OOI) and higher one-year mortality (640 vs 1.131 p<0,001). Among DM patients, organ damage was associated with higher in-hospital (200 vs 321 and one-year mortality (247 vs 393 Multivaliate analyses showed an independent association of DM with in-hospital (odds ratio [OR] = 1,34, 95% confidence interval (Cll: 1,16-1,55, p<O.001) and one-year mortality (OR = 1,38, 95% Ch 1,21-1,59, Among DM patients, organ damage was independently associated with higher in-hospital (OR = 1,37, 95% Cl: 1,06-1,76, p=O,015) and one-year mortality (OR=1,59, 95% Cl =1,26-2,01, p<0,001). Conclusions. The prevalence of DM among patients with IE is increasing and is already above 30%. 0M is independently associated with a poor prognosis, particularly in the case of DM with organ &mage.