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Department of Neurology, The Cleveland Clinic Foundation, Cleveland, OH (Drs. Salgado and Furlan)
Department of Infectious Diseases, The Cleveland Clinic Foundation, Cleveland, OH (Dr. Keys)
Department of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, Cleveland, OH (Mr. Nichols and Dr. Beck).
We reviewed the neurologic complications in 113 patients with native and 62 patients with prosthetic valve endocarditis. Neurologic complications occurred with the same frequency (35.3% vs 38.7%) and distribution among the two groups. Death occurred in 20.6% of patients with neurologic complications and in 13.6% of patients without neurologic complications (p = 0.23). Staphylococcus aureus endocarditis correlated statistically with the development of neurologic complications (p < 0.01) and death (p < 0.01). Among 50 patients discharged from the hospital after receiving only medical treatment for native valve endocarditis, and followed for a mean period of 48 months, there was one patient with mitral valve prolapse and stroke. We conclude that (1) neurologic complications occur with the same frequency in native and prosthetic valve endocarditis, (2) S aureus endocarditis increases the risk of neurologic complications and death, (3) mortality is not significantly increased in patients with neurologic complications, and (4) an episode of treated native valve endocarditis does not increase the natural history of stroke in valvular disease.
Address correspondence and reprint requests to Dr. Furlan, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44106.
Received June 1, 1988. Accepted for publication in final form August 11, 1988.
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