{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T15:18:47Z","timestamp":1790954327469,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T00:00:00Z","timestamp":1536019200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Infective endocarditis (IE) is a severe infection conferring significant morbidity and mortality. It is associated with geographical variation, complicating diagnosis and treatment of patients in a standardised manner.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the presentation, treatment and outcomes of patients with IE in the Hunter New England Local Health District (HNELHD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 112 patients with definite IE admitted to hospitals within the HNELHD between 2011 and 2015 was retrospectively analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of patients was 56.8 (standard deviation 20.3) and 62.5% were male. The most common valve affected was the mitral valve, in 41% of patients, and the most common organism was <jats:styled-content style=\"fixed-case\"><jats:italic>Staphylococcus aureus<\/jats:italic><\/jats:styled-content>, in 47.7% of patients. A history of IE was present in 10% of patients and 19.6% presented with prosthetic valve IE. Survival among patients treated surgically was 100% at 30 days, 92% at 1 year and 83% at 3 years, versus 82% at 30 days, 65% at 1 year and 51% at 3 years for those not operated (<jats:italic>P<\/jats:italic> = 0.004). Valve type, organism and Australian Standard Geographical Classification remoteness area did not have a statistically significant effect on mortality (<jats:italic>P<\/jats:italic>\u2010value 0.095, 0.456 and 0.186, respectively). Factors associated with improved survival by univariate analysis included surgery and multidisciplinary team review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>IE in the HNELHD affects a relatively young cohort of patients and is associated with a high mortality. Outcomes could be improved by implementation of a multidisciplinary team approach and inpatient cardiac surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13797","type":"journal-article","created":{"date-parts":[[2018,3,24]],"date-time":"2018-03-24T00:58:29Z","timestamp":1521853109000},"page":"1109-1116","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Infective endocarditis: a Hunter New England perspective"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8710-8214","authenticated-orcid":false,"given":"Fiona","family":"Doig","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Loewenthal","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases John Hunter Hospital  Newcastle New South Wales Australia"},{"name":"School of Medicine and Public Health, The University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases John Hunter Hospital  Newcastle New South Wales Australia"},{"name":"School of Medicine and Public Health, The University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Mejia","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0609-674X","authenticated-orcid":false,"given":"Ajay","family":"Iyengar","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,4]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Spelman D Calderwood SB Aldea G Kasner S Bolger A Baron Eet al.Complications and outcome of infective endocarditis. UpToDate.2017[cited 2016 May 20]. Available from URL:https:\/\/www.uptodate.com\/contents\/complications-and-outcome-of-infective-endocarditis?source=see_link"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp285"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000296"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2008.603"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq110"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2011.03.013"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2014.02.010"},{"key":"e_1_2_6_9_1","unstructured":"HNELHD. About Hunter New England Population Health.2016[cited 2016 May 20]. 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