Patient selection: infective endocarditis after a procedure
Procedures were performed as inpatients or outpatients.
High-risk patients for infective endocarditis:
(1) prior history of infective endocarditis
(2) prosthetic cardiac valve
(3) prosthetic material used for cardiac valve repair
(4) unrepaired cyanotic congenital heart disease
(5) palliative shunts or conduits
(6) cardiac transplantation
Cardiac procedures preceding infective endocarditis include:
(1) coronary artery bypass grafting (CABG)
(2) coronary angiography
(3) percutaneous coronary intervention (PCI)
(4) other cardiovascular therapeutic procedures
Endoscopy procedures preceding infective endocarditis include:
(1) bronchoscopy
(2) colonoscopy
(3) gastroscopy
(4) other types of transluminal endoscopy
Other procedures preceding infective endocarditis include:
(1) dialysis
(2) hemofiltration
(3) bone marrow biopsy
(4) blood transfusion
(5) noncardiac angiography
(6) arterial puncture
(7) therapeutic ENT procedure
(8) intracranial procedure
(9) skin and wound procedures
(10) genitourinary or obstetrical proceduress
Take-home messages:
(1) A patient undergoing a nondental invasive procedure may subsequently develop infective endocarditis.
(2) The risk is greater for patients at high risk for endocarditis.
(3) Steps should be taken to reduce the risk.
(4) The patient should be monitored for signs and symptoms that may indicate endocarditis.
Limitations:
• The procedures on inpatients were performed 0 to 84 days prior to infective endocarditis.
• The procedures on outpatients were performed 365 to 449 days prior to infective endocarditis.
• The impact of antibiotic prophylaxis was not studied.
• Information about the species causing endocarditis was lacking.
• This is an observational study.
• There is a need to avoid the post hoc fallacy in such a study.
