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The Usual Suspects' but Always Ignored: The Nutritional and Immune System's Status Affect the Infective Endocarditis Hospital Mortality

Received: 6 April 2020     Accepted: 5 May 2020     Published: 14 May 2020
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Abstract

The therapy of Infective Endocarditis is a very long and difficult. There are many factors that affected the management of therapy. Among them, maybe the most ignored factor belongs to the patient's' immune-nutrition status. Even though this assessment is more complicated; in recent years, prognostic nutritional index (PNI) was an established that inflammation-based nutritional score and the lymphocyte to-CRP ratio (LCR) was accepted as a marker of immune-inflammation's marker. Our study is aimed to investigate the relationship between LCR and PNI values and in-hospital mortality. Our comprehensive tertiary cardiology hospital in Turkey was included in this observational study, 36 patients with definite infective endocarditis were enrolled. We calculated LCR and PNI index from blood samples results of first hospitalization day. P-value < 0.05 was considered as statistically significant. In hospital mortality occurred in 12 (33%). LCR index was significantly lower in hospital mortality group (p=0.04) PNI index was also lower in hospital mortality group but it was not significant. The nutritional and immune system's status of the patient at the beginning of the treatment determines the hospital mortality of the patient during challenging treatment. In this context, the assessment of the PNI index and lymphocyte to-CRP ratio could aid physicians in determining hospital mortality risk and could affect the management of infective endocarditis patients.

Published in International Journal of Immunology (Volume 8, Issue 1)
DOI 10.11648/j.iji.20200801.12
Page(s) 9-12
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Endocarditis, Nutrition, Immune System

References
[1] Wang A, Gaca JG, Chu VH, Management Considerations in Infective Endocarditis: A Review. JAMA, 2018; 320 (1): 72-83.
[2] Tleyjeh IM, Abdel-Latif A, Rahbi H, Scott CG, Bailey KR, Steckelberg JM, Wilson WR, Baddour LM, A systematic review of population-based studies of infective endocarditis. Chest. 2007; 132 (3): 1025.
[3] Selton-Suty C, Célard M, Le Moing V, Doco-Lecompte T, Chirouze C, Iung B, Strady C, Revest M, Vandenesch F, Bouvet A, Delahaye F, Alla F, Duval X, Hoen B, AEPEI Study Group. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey. Clin Infect Dis. 2012 May; 54 (9): 1230-9.
[4] Pant S, Patel NJ, Deshmukh A, Golwala H, Patel N, Badheka A, Hirsch GA, Mehta JL. Trends in infective endocarditis incidence, microbiology, and valve replacement in the United States from 2000 to 2011. J Am Coll Cardiol. 2015; 65 (19): 2070.
[5] Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, Dulgheru R, El Khoury G, Erba PA, Iung B, Miro JM, Mulder BJ, Plonska-Gosciniak E, Price S, Roos-Hesselink J, Snygg-Martin U, Thuny F, Tornos Mas P, Vilacosta I, Zamorano JL; ESC Scientific Document Group. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM).(2015) Eur Heart J. 21; 36 (44): 3075-3128.
[6] Kono T, Sakamoto K, Shinden S, Ogawa K. Pre-therapeutic nutritional assessment for predicting severe adverse events in patients with head and neck cancer treated by radiotherapy. (2017) Clin Nutr; 36 (6): 1681e5.
[7] Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. (1984) Nihon Geka Gakkai Zasshi; 85 (9): 1001.
[8] Okugawa Y, Toiyama Y, Yamamoto A, Shigemori T, Ichikawa T, Yin C, Suzuki A, Fujikawa H, Yasuda H, Hiro J, Yoshiyama S, Ohi M, Araki T, McMillan DC, Kusunoki M. Lymphocyte-to-C-reactive protein ratio and score are clinically feasible nutrition-inflammation markers of outcome in patients with gastric cancer. (2019) Clin Nutr. 21. pii: S0261-5614 (19) 30220-1.
[9] Habib G, Erba PA, Iung B, Donal E, Cosyns B, Laroche C, Popescu BA, Prendergast B, Tornos P, Sadeghpour A, Oliver L, Vaskelyte JJ, Sow R, Axler O, Maggioni AP, Lancellotti P; EURO-ENDO Investigators. Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study. (2019) Eur Heart J, 40 (39): 3222-3232.
[10] Mohri Y, Inoue Y, Tanaka K, Hiro J, Uchida K, Kusunoki M. Prognostic nutritional index predicts postoperative outcome in colorectal cancer (2013) World J Surg.; 37 (11): 2688-92.
[11] Hu Y, Shen J, Liu R, Feng Z, Zhang C, Ling L, Chen L. Prognostic value of pretreatment prognostic nutritional index in non-small cell lung cancer: A systematic review and meta-analysis (2018) Int J Biol Markers, 33 (4): 372-378.
[12] Yoshihisa A, Kanno Y, Watanabe S, Yokokowa T, Abe S, Miyata M, Sato T, Suzuki S, Oikawa M, Kobayashi A, Yamaki T, Kunii H, Nakazato K, Suzuhi H, Ishida T, Takeishi Y. Impact of nutrional indices on mortality in patients with heart failure. (2018) Open Heart, 9; 5 (1): e000730.
[13] Wada H Dohi T, Miyauchi K, Endo H, Tsuboi S, Ogita M, Kasai T, Okazaki S, Isoda K, Suwa S, Daida H. Combined effect of nutritional status on long-term outcomes in patients with coronary artery disease undergoing percutaneous coronary intervention Heart Vessels. (2018) 33 (12): 1445-1452.
[14] Ścisło L, Bizoń A, Walewska E, Staszkiewicz M, Pach R, Szczepanik A. Nutritional Status of Elderly Patients after Coronary Artery Bypass Surgery. (2019) Int J Environ Res Public Health. 15; 16 (2).
[15] Meshaal MS, Nagi A, Eldamaty A, Elnaggar W, Gaber M, Rizk H. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as independent predictors of outcome in infective endocarditis (IE).(2019) Egypt Heart J.; 71 (1): 13.
Cite This Article
  • APA Style

    Ozlem Arican Ozluk, Ayse Akdeniz, Elif Guclu, Burcu Tuncay, Tahsin Bozat. (2020). The Usual Suspects' but Always Ignored: The Nutritional and Immune System's Status Affect the Infective Endocarditis Hospital Mortality. International Journal of Immunology, 8(1), 9-12. https://doi.org/10.11648/j.iji.20200801.12

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    ACS Style

    Ozlem Arican Ozluk; Ayse Akdeniz; Elif Guclu; Burcu Tuncay; Tahsin Bozat. The Usual Suspects' but Always Ignored: The Nutritional and Immune System's Status Affect the Infective Endocarditis Hospital Mortality. Int. J. Immunol. 2020, 8(1), 9-12. doi: 10.11648/j.iji.20200801.12

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    AMA Style

    Ozlem Arican Ozluk, Ayse Akdeniz, Elif Guclu, Burcu Tuncay, Tahsin Bozat. The Usual Suspects' but Always Ignored: The Nutritional and Immune System's Status Affect the Infective Endocarditis Hospital Mortality. Int J Immunol. 2020;8(1):9-12. doi: 10.11648/j.iji.20200801.12

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  • @article{10.11648/j.iji.20200801.12,
      author = {Ozlem Arican Ozluk and Ayse Akdeniz and Elif Guclu and Burcu Tuncay and Tahsin Bozat},
      title = {The Usual Suspects' but Always Ignored: The Nutritional and Immune System's Status Affect the Infective Endocarditis Hospital Mortality},
      journal = {International Journal of Immunology},
      volume = {8},
      number = {1},
      pages = {9-12},
      doi = {10.11648/j.iji.20200801.12},
      url = {https://doi.org/10.11648/j.iji.20200801.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.iji.20200801.12},
      abstract = {The therapy of Infective Endocarditis is a very long and difficult. There are many factors that affected the management of therapy. Among them, maybe the most ignored factor belongs to the patient's' immune-nutrition status. Even though this assessment is more complicated; in recent years, prognostic nutritional index (PNI) was an established that inflammation-based nutritional score and the lymphocyte to-CRP ratio (LCR) was accepted as a marker of immune-inflammation's marker. Our study is aimed to investigate the relationship between LCR and PNI values and in-hospital mortality. Our comprehensive tertiary cardiology hospital in Turkey was included in this observational study, 36 patients with definite infective endocarditis were enrolled. We calculated LCR and PNI index from blood samples results of first hospitalization day. P-value < 0.05 was considered as statistically significant. In hospital mortality occurred in 12 (33%). LCR index was significantly lower in hospital mortality group (p=0.04) PNI index was also lower in hospital mortality group but it was not significant. The nutritional and immune system's status of the patient at the beginning of the treatment determines the hospital mortality of the patient during challenging treatment. In this context, the assessment of the PNI index and lymphocyte to-CRP ratio could aid physicians in determining hospital mortality risk and could affect the management of infective endocarditis patients.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - The Usual Suspects' but Always Ignored: The Nutritional and Immune System's Status Affect the Infective Endocarditis Hospital Mortality
    AU  - Ozlem Arican Ozluk
    AU  - Ayse Akdeniz
    AU  - Elif Guclu
    AU  - Burcu Tuncay
    AU  - Tahsin Bozat
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    DO  - 10.11648/j.iji.20200801.12
    T2  - International Journal of Immunology
    JF  - International Journal of Immunology
    JO  - International Journal of Immunology
    SP  - 9
    EP  - 12
    PB  - Science Publishing Group
    SN  - 2329-1753
    UR  - https://doi.org/10.11648/j.iji.20200801.12
    AB  - The therapy of Infective Endocarditis is a very long and difficult. There are many factors that affected the management of therapy. Among them, maybe the most ignored factor belongs to the patient's' immune-nutrition status. Even though this assessment is more complicated; in recent years, prognostic nutritional index (PNI) was an established that inflammation-based nutritional score and the lymphocyte to-CRP ratio (LCR) was accepted as a marker of immune-inflammation's marker. Our study is aimed to investigate the relationship between LCR and PNI values and in-hospital mortality. Our comprehensive tertiary cardiology hospital in Turkey was included in this observational study, 36 patients with definite infective endocarditis were enrolled. We calculated LCR and PNI index from blood samples results of first hospitalization day. P-value < 0.05 was considered as statistically significant. In hospital mortality occurred in 12 (33%). LCR index was significantly lower in hospital mortality group (p=0.04) PNI index was also lower in hospital mortality group but it was not significant. The nutritional and immune system's status of the patient at the beginning of the treatment determines the hospital mortality of the patient during challenging treatment. In this context, the assessment of the PNI index and lymphocyte to-CRP ratio could aid physicians in determining hospital mortality risk and could affect the management of infective endocarditis patients.
    VL  - 8
    IS  - 1
    ER  - 

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Author Information
  • Department of Cardiology, Bursa Ihtisas Training and Research Hospital, Bursa, Turkey

  • Department of Cardiology, Bursa Ihtisas Training and Research Hospital, Bursa, Turkey

  • Department of Cardiology, Bursa Ihtisas Training and Research Hospital, Bursa, Turkey

  • Department of Cardiology, Bursa Ihtisas Training and Research Hospital, Bursa, Turkey

  • Department of Cardiology, Bursa Ihtisas Training and Research Hospital, Bursa, Turkey

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