Clinical and echocardiographic predictors of embolism in infective endocarditis: systematic review and meta-analysis

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
A YangN K J Adhikari

Abstract

Prediction of embolic events (EEs) in infective endocarditis (IE) could inform clinical decisions, such as surgical timing. We conducted a systematic review to more precisely define associations between risk factors and EEs. We searched two bibliographic databases (1994-2018) for observational studies that reported EEs in IE patients and considered clinical, microbiological or echocardiographic risk factors. Studies that did not use Duke criteria or only investigated a subset of IE patients were excluded. Study quality was assessed using the Newcastle-Ottawa scale. A pooled risk ratio (RR) for each risk factor was estimated using random-effects models; statistical heterogeneity was estimated using I2. Of 3862 unique citations, 47 cohort studies (11 215 IE cases) were included; 54 risk factors were analysed in at least two studies, with nine studies reporting other individual factors. Most studies were of high methodological quality. Major predictors of EEs were intravenous drug use (RR 1.69, 95% CI 1.32-2.17; I2 = 46%), Staphylococcus aureus infection (RR 1.64, 95% CI 1.45-1.86, I2 = 32%), mitral valve vegetation (RR 1.24, 95% CI 1.11-1.37, I2 = 30%), and vegetation size >10 mm (RR 1.87, 95% CI 1.57-2.21, I2 = 48%). EE risk was...Continue Reading

Citations

Jun 13, 2019·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Hakan ErdemCanan Agalar
Dec 23, 2020·The Journal of International Medical Research·Jian ZhaoNa Li
Feb 3, 2021·Clinical Cardiology·Wangling HuGuanhua Su
Feb 5, 2021·Journal of the American College of Cardiology·Juan M PericàsUNKNOWN International Collaboration on Endocarditis (ICE) Investigators
Jan 1, 2022·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Gonzalo CabezónJ Alberto San Román
Feb 5, 2022·Anesthesiology·Henning HermannsBenedikt Preckel

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