Infective endocarditis: Absence of microbiological diagnosis is an independent predictor of inhospital mortality

Infective endocarditis (IE) is associated with high inhospital mortality. New microbiological diagnostic techniques have reduced the proportion of patients without etiological diagnosis, but in a significant number of patients the cause is still unknown. Our aim was to study the association of the absence of microbiological diagnosis with in-hospital prognosis. Prospective cohort of 2000 consecutive patients with IE. Data were collected in 26 Spanish hospitals. Modified Duke criteria were used to diagnose patients with suspected IE. A total of 290 patients (14.8%) had negative blood cultures. Etiological diagnosis was achieved with other methods (polymerase chain reaction, serology and other cultures) in 121 (6.1%). Finally, there were 175 patients (8.8%) without microbiological diagnosis (Group A) and 1825 with diagnosis (Group B). In-hospital mortality occurred in 58 patients in Group A (33.1%) vs. 487 (26.7%) in Group B, p = 0.07. Patients in Group A had a lower risk profile than those in Group B, with less comorbidity (Charlson index 1.9 ± 2.0 vs. 2.3 ± 2.1, p = 0.03) and lower surgical risk (EuroSCORE 23.6 ± 21.8 vs. 29.6 ± 25.2, p = 0.02). However they presented heart failure more frequently (53% vs. 40%, p = 0.005). Multivariate analysis showed that the absence of microbiological diagnosis was an independent predictor of inhospital mortality (odds ratio 1.8, 95% Confidence Interval 1.1–2.9, p = 0.016). Approximately 9% of patients with IE had no microbiological diagnosis. Absence of microbiological diagnosis was an independent predictor of inhospital mortality.

Using a brief questionnaire to assess the overall perception of basketball spectators

Purpose – The purpose of this paper is twofold. The first aim is to obtain a valid and reliable instrument for the holistic analysis of sporting events, and the second is to test a causal model in which future intentions depend on spectators’ perceptions of quality, satisfaction, and value of these events. Design/methodology/approach – A total of 493 spectators of a professional basketball team in the Spanish ACB league responded to a survey to measure the overall performance of the sporting event service. Exploratory factor analysis and further confirmatory factor analysis using structural equation models provides the methodology for testing the reliability and validity of the instrument. Findings – The scales have adequate reliability and validity indices. The path model explains 35.8 percent of the variance in future intentions, 54.0 percent in perceived value, and 49.5 percent in spectators’ satisfaction. Quality proves a better predictor of perceived value than satisfaction. Both perceived value and satisfaction have a similar weight in predicting spectators’ future intentions. The data indicate that quality has an effect on spectators’ future intentions, by altering their perceptions of value and satisfaction. Research limitations/implications – The research findings are somewhat limited, due to the sample consisting entirely of spectators of a single team in the Spanish ACB league. Practical implications – Managers can use these findings to develop loyalty strategies by creating service value and increasing spectators’ satisfaction through quality improvements. Originality/value – This study contributes to the literature on service quality by providing an overall measure to assess service in professional sporting events in a Latin-American context.