Title : Diagnosis and management of infective endocarditis in a district general hospital: A retrospective review (2020–2024)
Abstract:
Background: Infective Endocarditis (IE) remains a complex and life-threatening condition with evolving epidemiology and diagnostic challenges. This study aims to characterise the presentation, management, and outcomes of IE in a non-surgical District General Hospital (DGH) setting in the UK. To our knowledge this is the most comprehensive UK based study of its kind for many years.
Methods: We conducted a retrospective analysis of adult patients with first presentations of definite or possible IE referred to the IE Multidisciplinary Team (MDT) between December 2020 and March 2024. Data were extracted from electronic health records and included demographics, comorbidities, microbiology, imaging, treatment, and outcomes.
Results: A total of 145 patients met inclusion criteria (mean age 74.2 years; 79% male). The incidence of IE was 12.7 per 100,000 person-years. Staphylococcus, streptococcus, and enterococcus species accounted for 76% of cases. Device-associated and prosthetic valve IE represented 10% and 19% of cases, respectively, with organism distribution varying significantly in these subgroups. Transthoracic echocardiography had limited sensitivity (44% positive rate), prompting further imaging in many cases. Surgical intervention was undertaken in 29% of patients. Inpatient mortality was 32%, with higher Charlson comorbidity scores among non-survivors.
Conclusion: This study reinforces known diagnostic and therapeutic complexities of IE, while highlighting potential subgroup-specific microbial patterns. Findings support the need for early diagnostic vigilance and may inform future multicentre investigations and local quality improvement initiatives.
