Proundly Supported by
Pfizer Foundation
    Home | Current Issue | Past Issue | Board | Instruction | Contact


Effect of Changes in Diagnosis and Management of Active Infective Endocarditis on the Clinical Outcome at Srinagarind Hospital

498

Orathai Pachirat, MD*, Songsak Kiatchoosakun, MD*
Ploenchan Chetchotisakd, MD*, Cherdchai Tantisirin, MD**,
Supon Limwattananon, MPHM, PhD***, Julaporn Limwattananon, MPHM, PhD***

* Department of Medicine, Khon Kaen University, Khon Kaen
** Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen
*** Department of Community Pharmacy, Faculty of Pharmaceuticle Sciences, Khon Kaen University, Khon Kaen

Abstract


Background: In recent years, diagnostic methods and treatment of infective endocarditis (IE) have been improved. It is not known whether the clinical outcome is any better.
Objective: To assess the effect of changes on the clinical outcomes of IE patients
Material and Method: The authors performed a retrospective study comparing IE patients hospitalized at Srinagarind hospital during the period from 1/1/1990 to 31/12/2002. The authors classified the patients according to the period of diagnosed from 1990 to 1993 (n = 57), 1994 to1997 (n = 71), and 1998 to 2002 (n = 72) cohorts.
Results: There were two hundred IE patients in the present study. Mean age and degenerative heart disease were increasing. Operative and in-hospital mortality were decreasing. Overall survival rate was 81% at the first year, 60% at 5 years, 55% at 12 years in surgically treated patients, with 30-day mortality in 27.1% mostly from the 1990 to1993 cohort. In medically treated IE, overall the survival rate was 37% in the first year, 32% at 5 years, 20% at 12 years, with 30-day mortality in 72.86% mostly in the 1990 to1993 cohort. Early surgical intervention, improved long-term survival rates (hazard ratio 0.23; 95%CI 0.14-0.37), severe congestive heart failure (hazard ratio 1.87; 95%CI 1.17-2.99) and renal failure (hazard ratio 4.10; 95%CI 2.05-7.84) are the predictors of mortality by multivariate analysis. Survival rate from 1998 to 2002 cohort was 85%, 1994 to 1997 cohort was 54% and 1993 to 1990 cohort was 27% at 1-year (p < 0.001).
Conclusion: The data indicated that the changing clinical outcome of this disease, reflected improvements in diagnostic method and treatment. Although IE remains a serious condition characterized by significant morbidity and mortality, the overall survival rate has significantly improved over time. The authors therefore, believe that early diagnosis and prompt treatment both medical or surgical interventions will improve the outcome of IE patients.

Keyword : Infective endocarditis, Survival and outcome



Download Full Paper
  Vol88_No4_498.pdf  [ 88.84 Kb]

Home | Current Issue | Past Issue | Board | Instruction | Contact

© Copyright The Medical Association of Thailand. All Rights Reserved.2001-2002
Acquista Cialis generico 5 mg Effetti collaterali del Cialis 5 mg Acquista Cialis 20mg online Prezzo di Cialis originale in Svizzera Acquista Viagra in Svizzera senza prescrizione Dove comprare Cialis 10mg Viagra in farmacia online effetti collaterali Costo di Cialis 5mg Opiniones de Reduslim Acquista Spedra Avanafil senza prescrizione Acquista Viagra in Svizzera senza prescrizione Comprar Cialis original Comprar Viagra Contrareembolso Cialis 5mg Viagra sin receta Cialis 5 mg efectos secundarios graves Reduslim precio Trastorno de la ereccin venta de tadalafilo avanafil prezzo cialis 20 mg prezzo cialis effetti benefici cialis 10 mg Reduslim Kaufen pulse crypto price prediction avanafil 100 mg prezzo buy cialis or generic tadalafil 9 http://diplomsagroups.com https://gosznac-diploma.com/ http://sreestrom.ru/ http://originality-diplomy.com https://russian-diplom.com 9 http://russdiplomiki.com https://diplomansy.com 11 https://diploms-asx.com http://diplomrussian.com 11 https://rudiplomisty24.com/ https://russiany-diploman.com/ https://land-diplom.com/ 11 https://kyc-diplom.com http://diploms-service.com https://originaly-dokuments.com https://diplomy-grup24.com/ http://aurus-diploms.com/kupit-diplom-stroitelya.html 9 https://diplomansy.com/kupit-diplom-s-reestrom http://diploms-service.com/diplomy-po-gorodam/novosibirsk 11 http://diplomyland.com/ https://premialnie-diplomansy.com https://diplomiki.com
https://aurus-diplomany.com
https://russiany-diplomana.com
https://originality-diplomik.com
https://lands-diplomy.com
https://okdiplom.com/
https://nsk-diplom.com/
https://ry-diplom.com/
https://diploms-vuza.com/
https://diplom-bez-problem.com/
https://kazdiplomas.com/
https://diplomoz-197.com/
https://kupit-diplomyz24.com/
https://prodiplome.com/
https://diplom5.com/
https://10000diplomov.ru/
https://1magistr.ru/
https://diplom-insti.ru/
https://kdiplom.ru/
https://diplom45.ru/
https://diplom-zakaz.ru/
https://peoplediplom.ru/
https://diplom-profi.ru/
https://bisness-diplom.ru/
https://kupite-diplom0024.ru/
11
11
11
https://diploman-asx.com
11
https://rudiplomirovany.com
https://premialnie-diploms.com
https://diplomans-doc.com
https://russiany-diplom.com
https://diplomy-gruppa.com
https://rudiplomis.com
https://rudiplomisty.com/
https://lands-diploms.com
https://originality-diploman.com
https://originality-diplomx24.com
https://originality-diploms24.com
https://originality-diploma24.com
https://originality-diploman24.com
https://originality-diplomans24.com
https://originality-diplomik24.com
https://originality-diplomix24.com
https://originality-diplomas24.com
9
https://originality-diplomiks24.com
https://originality-diplomiki24.com
https://ru-diplomirovan.com
https://ru-diplomirovany.com
www.ru-diplomirovanay.com
https://ru-diplomirovannie.com
rudiplomir.com
rudiplomirs.com
www.rudiplomira.com
rudiplomiry.com
https://rudiplomiru.com
ab-diplom24.ru
www.ab-diplom24.ru
http://www.24diplom07.ru
http://landik-attestats365.com
http://study-diploms.com}
9
11
9
http://diplomsagroups.com/kupit-diplom-o-srednem-obrazovanii/diplom-o-srednem-i-srednem-specialnom-obrazovanii.html
11
http://diplomsagroups.com/kupit-attestat-shkoly.html
https://premialnie-diplomansy.com/----/
https://premialnie-diplomansy.com/----/
https://premialnie-diplomansy.com/--/
https://russiany-diplomans.com/attestat-9-klassov
https://russiany-diplomans.com/srednee-spetsialnoe-obrazovanie
https://russiany-diplomans.com/kupit-diplom-kolledzha
https://russiany-diplomans.com/diplom-magistra
http://lands-diploms.com/ http://lands-diploms.com/specialnosti/yurist.html http://lands-diploms.com/goroda/krasnodar.html http://lands-diploms.com/goroda/omsk.html http://lands-diploms.com/goroda/chelyabinsk.html
http://aurus-diploms.com/attestat-9-klass.html http://aurus-diploms.com/obrazovanie/kupit-diplom-s-zaneseniem-v-reestr.html http://aurus-diploms.com/diplom-magistra.html http://aurus-diploms.com/geography/kupit-diplom-v-samare.html
http://radiploma.com/kupit-diplom-s-reestrom http://radiploma.com/kupit-diplomy-tehnikuma-kolledzha http://radiploma.com/kupit-diplomy-o-srednem-tehnicheskom-obrazovanii http://radiploma.com/kupit-diplom-kosmetologa
https://aurus-diplomans.com http://www.diplomas-asx.com https://diplomana-asx.com www.rusd-diplom.com https://rusd-diploms.com https://aurus-diplomany.com https://aurus-diplomik.com www.aurus-diplomas.com https://diplomans-asx.com diplomany-asx.com http://www.diplomys-asx.com https://diploman-servise.com http://www.radiploms.com http://www.radiplom.com radiplomy.com radiploma.com rudiplomisty24.com/--- http://www.rudiplomisty24.com/--- www.rudiplomisty24.com/--- rudiplomisty24.com/--
www.originality-diploman.com/----- originality-diploman.com/- originality-diploman.com/- www.originality-diploman.com/--
www.gosznac-diplomy.com/kupit-diplom-o-srednem-texnicheskom-obrazovanii www.gosznac-diplomy.com/diplom-spetcialista https://gosznac-diplomy.com/kupit-diplom-v-cheliabinske
diploman-asx.com/kupit-diplom-moskva https://diploman-asx.com/otzyvy http://www.diploman-asx.com/kupit-diplom-bakalavra-ili-specialista https://diploman-asx.com/kupit-diplom-specialista
11
http://www.diplom-belarus.com
diplomi-price.com
edu-digest.ru
http://proobzh.ru
http://www.edu-nt.ru/
http://www.student-madi.ru
http://dof-edu.ru
9
http://proobzh.ru
www.krsk-school47.ru http://www.russdiplomik.com/kupit-diplom-v-moskve.html russdiplomik.com/diplom-farmaczevta.html russdiplomik.com/diplom-s-reestrom-o-vyisshem-obrazovanii.html http://www.russdiplomik.com/kupit-diplom-v-novosibirske.html
http://www.russdiplomik.com/diplom-czena.html www.russdiplomik.com/diplom-farmaczevta.html russdiplomik.com/kupit-diplom-sankt-peterburg.html russdiplomik.com/kupit-diplom-v-ekaterinburge.html https://russiany-diplomans.com/diplom-o-srednem-obrazovanii http://www.russiany-diplomans.com/kupit-diplom-vracha www.russiany-diplomans.com/kupit-diplom-ekaterinburg http://www.russiany-diplomans.com/kupit-diplom-pskov https://arena-diplom24.com/attestaty https://arena-diplom24.com/diplomy-po-spetsialnosti/diplom-yurista https://ryazan.arena-diplom24.com/ http://www.novorossijsk.arena-diplom24.com/ www.diploms-goznak.com/attestat-vechernej-shkoly http://diploms-goznak.com/kupit-diplom-v-dnepropetrovske http://www.diploms-goznak.com/kupit-diplom-v-zhitomire http://diploms-goznak.com/kupit-diplom-v-zaporozhe - www.diploms-goznak.com/kupit-diplom-v-odesse diploms-goznak.com/vrach www.diploms-goznak.com/diplom-uchilishcha www.diploms-goznak.com/diplom-starogo-obraztsa http://www.diploms-goznak.com/diplom-tekhnikuma-kolledzha diploms-goznak.com/farmatsevt diploms-goznak.com/yurist http://diploms-goznak.com/meditsinskij-diplom diploms-goznak.com/svidetelstvo-o-rozhdenii
https://diplomy-servise.com
diploman-dok.com
diploman-doks.com
diploman-doky.com
www.diploman-doku.com http://education-ua.com/kupit-legalnyij-diplom-v-ukraine.html
www.education-ua.com/attestat-diplom.html
education-ua.com/zaporozhe.html
education-ua.com/kieve.html
http://education-ua.com/odesse.html
http://education-ua.com/summah.html
9
http://education-ua.com/ternopole.html
education-ua.com/diplom-o-mediczinskom-obrazovanii.html
http://www.education-ua.com/diplom-vyisshee.html
http://education-ua.com/kupit-nastoyashhij-diplom-goznak.html
http://www.education-ua.com/
education-ua.com/diplom-texnikuma-kolledzha.html
education-ua.com/diplom-magistra-ukrainskogo-vuza.html
http://www.education-ua.com/diplom-o-mediczinskom-obrazovanii.html
http://www.education-ua.com/diplom-medsestry.html
www.education-ua.com/diplom-nedorogo.html
http://education-ua.com/kupit-diplom-novogo-obrazca.html
www.education-ua.com/otzivi-pogelania.html
www.education-ua.com/diplom-vyisshee.html
http://education-ua.com/diplom-uchilishha.html
http://education-ua.com/diplom-s-registracziej.html
http://www.education-ua.com/kupit-diplom-s-provodkoj-v-ukraine.html
http://www.education-ua.com/diplom-specialista-ukrainskogo-vuza.html
http://www.education-ua.com/diplom-uchilishha.html
http://www.education-ua.com/kupit-diplom-sssr-na-nastoyashhem-blanke.html
http://education-ua.com/svidetelstvo-o-rozhdenii.html
11
http://education-ua.com/svidetelstvo-o-smerti.html
education-ua.com/svidetelstvo-o-brake.html
www.education-ua.com/svidetelstvo-o-razvode.html http://rudiplomisty24.com/-11- https://diplomy-servise.com http://dipplomy.com www.egpu.ru http://vina-net.ru/ cursovik.ru www.spravkipiter.ru alcoself.ru www.school625.ru www.moek-college.ru www.mmcmedclinic.ru www.intimvisit.ru http://med-pravo.ru/ http://moskva-medcentr.ru/ intim-72.ru razigrushki.ru www.dgartschool.ru www.ftbteam.ru http://sb26.ru/ http://www.originaly-dokuments.com/attestaty/attestat-za-9-klass https://originaly-dokuments.com/diplom-o-srednem-spetsialnom-obrazovanii https://originaly-dokuments.com/gorod/nizhnij-tagil https://originaly-dokuments.com/gorod/vologda www.originaly-dokuments.com/gorod/saratov https://originaly-dokuments.com/spetsialnosti/yurist originaly-dokuments.com/spetsialnosti/povar www.originaly-dokuments.com/gorod/krasnodar originaly-dokuments.com/attestaty/attestat-za-11-klass http://www.originaly-dokuments.com/gorod/ekaterinburg www.originaly-dokuments.com/attestaty https://originaly-dokuments.com/spetsialnosti/bukhgalter www.originaly-dokuments.com/gorod/omsk originaly-dokuments.com/gorod/novosibirsk www.originaly-dokuments.com/gorod/sankt-peterburg originaly-dokuments.com/gorod/chelyabinsk www.originaly-dokuments.com/gorod/orjol originaly-dokuments.com/diplom-o-vysshem-obrazovanii/diplom-bakalavra originaly-dokuments.com/diplom-o-vysshem-obrazovanii/diplom-magistra www.originaly-dokuments.com/spetsialnosti/menedzher https://originaly-dokuments.com/diplom-o-srednem-spetsialnom-obrazovanii/diplom-kolledzha https://originaly-dokuments.com/diplom-o-srednem-spetsialnom-obrazovanii
- - - -- - - premialnie-diplomansy.com https://premialnie-diplomansy.com/--/ www.premialnie-diplomansy.com www.originality-diploman.com originality-diploman.com https://originality-diploman.com/-- originality-diploman.com https://originality-diploman.com/-- https://originality-diploman.com/---- www.originality-diploman.com http://https://originality-diploman.com/-- premialnie-diplomansy.com originality-diploman.com www.premialnie-diplomansy.com premialnie-diplomansy.com https://premialnie-diplomansy.com/--/ https://premialnie-diplomansy.com/--/ www.premialnie-diplomansy.com www.premialnie-diplomansy.com http://https://originality-diploman.com/--
9
www.gosznac-diplomy.com http://https://gosznac-diplomy.com/kupit-diplom-vuza-rossii http://https://gosznac-diplomy.com/diplom-sredne-spetcialnoe-obrazovanie http://https://gosznac-diplomy.com/kupit-diplom-v-moskve gosznac-diplomy.com gosznac-diplomy.com https://gosznac-diplomy.com/svidetelstvo-o-rozhdenii http://https://gosznac-diplomy.com/diplom-feldshera gosznac-diplomy.com https://gosznac-diplomy.com/diplom-stroitelya
9 9 11
originality-diplomans.com
rudiplomis24.com
www.diploma-asx.com
https://gosznac-diplom.com/ diploman-doci.com
https://originality-diplomans.com/
www.rudiplomis24.com
https://lands-diplom.com/
https://gosznac-diplom.com/ http://https://aurus-diplom.com/
https://originality-diplomans.com/
https://rudiplomista24.com/
www.diploma-asx.com
https://gosznac-diplom.com/ https://aurus-diplom.com/
http://https://originality-diplomans.com/
https://rudiplomista24.com/
https://lands-diplom.com/
www.gosznac-diplom.com http://https://aurus-diplom.com/
http://diplomsagroups.com/diplomy-po-specialnosti/diplom-buhgaltera.html www.originality-diploman24.com https://originality-diplomans.com/ https://originality-diploma24.com/- http://https://frees-diploma.com https://ekaterinburg.arena-diplomi24.com/ http://https://ekaterinburg.arena-diplomi24.com/