-
Something wrong with this record ?
Association between the timing of surgery for complicated, left-sided infective endocarditis and survival
A. Wang, VH. Chu, E. Athan, F. Delahaye, T. Freiberger, C. Lamas, JM. Miro, J. Strahilevitz, C. Tribouilloy, E. Durante-Mangoni, JM. Pericas, N. Fernández-Hidalgo, F. Nacinovich, B. Barsic, E. Giannitsioti, JP. Hurley, MM. Hannan, LP. Park,...
Language English Country United States
Document type Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't
NLK
ProQuest Central
from 2002-01-01 to 2 months ago
Nursing & Allied Health Database (ProQuest)
from 2002-01-01 to 2 months ago
Health & Medicine (ProQuest)
from 2002-01-01 to 2 months ago
Health Management Database (ProQuest)
from 2002-01-01 to 2 months ago
Public Health Database (ProQuest)
from 2002-01-01 to 2 months ago
- MeSH
- Abscess mortality MeSH
- Acute Disease MeSH
- Endocarditis, Bacterial mortality pathology surgery MeSH
- Time-to-Treatment * MeSH
- Surgical Procedures, Operative MeSH
- Adult MeSH
- Hospitalization MeSH
- Middle Aged MeSH
- Humans MeSH
- Patient Transfer statistics & numerical data MeSH
- Proportional Hazards Models MeSH
- Prospective Studies MeSH
- Risk Factors MeSH
- Aged MeSH
- Heart Failure epidemiology etiology MeSH
- Staphylococcal Infections mortality MeSH
- Staphylococcus aureus MeSH
- Propensity Score MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: In patients with active infective endocarditis (IE), the relationship between timing of surgery and survival is uncertain. The objective was to evaluate clinical characteristics associated with timing of surgery and the association between surgical timing and 6-month survival in complicated, left-sided IE. METHODS: In a prospective, multicenter, observational registry (The International Collaboration on Endocarditis-PLUS, registry from 2008 to 2012), clinical factors associated with timing of surgery during the index hospitalization were determined among 485 adult patients with definite, complicated, left-sided IE who underwent cardiac surgery during their index hospitalization. The relationship between early surgical intervention (<7 days from admission to surgery center) and outcome after surgery was analyzed. The primary end point of the study was 6-month survival. RESULTS: The median time to surgery from admission to surgical center was 7 (interquartile range 2-15) days. Patients who underwent earlier surgery were more likely transferred to the surgical center (74.2% vs 46.4%, P < .001) and had a lower percentage of preexisting heart failure (before IE diagnosis) (6.0% vs 17.3%, P < .001) but higher rate of acute heart failure (53.2% vs 38.4%, P = .001). Variables independently associated with surgery <7 days from admission were patient transfer, acute heart failure, and nonelective surgical status (C-index = 0.84), but predicted operative risk was not. Cox proportional hazards modeling with inverse probability of treatment weighting found that earlier surgery was associated with a trend toward higher 6-month mortality compared with later surgery (hazard ratio = 1.68, 95% CI 0.97-2.96; P = .065), particularly surgery within 2 days of admission or transfer. Mortality was significantly associated with operative risk and complicated IE, including Staphylococcus aureus infection and presence of abscess. CONCLUSIONS: Earlier surgery in IE is strongly associated with acute heart failure and surgical urgency. After adjustment for operative risk and IE complications, earlier surgery <7 days from admission was associated with a trend toward higher 6-month overall mortality compared with surgery later in the index hospitalization.
Attikon University General Hospital Athens Greece
Barwon Health and Deakin University Geelong Australia
Duke University Medical Center Durham NC
Hadassah Hebrew University Medical Center Jerusalem Israel
Hospital Louis Pradel Lyon Bron France
Infectious Diseases Service Hospital Clinic IDIBAPS University of Barcelona Barcelona Spain
Instituto Cardiovascular de Buenos Aires Buenos Aires Argentina
Instituto Nacional de Cardiologia and Unigranrio Rio de Janeiro Brazil
Internal Medicine University of Campania Monaldi Hospital Naples Italy
Mater Misericordiae University Hospital Dublin Ireland
School of Medicine University of Zagreb Hospital for Infectious Diseases Zagreb Croatia
University Hospital Amiens France and INSERM U 1088 University of Picardie Amiens France
References provided by Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc19044969
- 003
- CZ-PrNML
- 005
- 20200113081532.0
- 007
- ta
- 008
- 200109s2019 xxu f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.1016/j.ahj.2019.01.004 $2 doi
- 035 __
- $a (PubMed)30802708
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a xxu
- 100 1_
- $a Wang, Andrew $u Duke University Medical Center, Durham, NC. Electronic address: a.wang@duke.edu.
- 245 10
- $a Association between the timing of surgery for complicated, left-sided infective endocarditis and survival / $c A. Wang, VH. Chu, E. Athan, F. Delahaye, T. Freiberger, C. Lamas, JM. Miro, J. Strahilevitz, C. Tribouilloy, E. Durante-Mangoni, JM. Pericas, N. Fernández-Hidalgo, F. Nacinovich, B. Barsic, E. Giannitsioti, JP. Hurley, MM. Hannan, LP. Park, ICE-PLUS Investigators,
- 520 9_
- $a BACKGROUND: In patients with active infective endocarditis (IE), the relationship between timing of surgery and survival is uncertain. The objective was to evaluate clinical characteristics associated with timing of surgery and the association between surgical timing and 6-month survival in complicated, left-sided IE. METHODS: In a prospective, multicenter, observational registry (The International Collaboration on Endocarditis-PLUS, registry from 2008 to 2012), clinical factors associated with timing of surgery during the index hospitalization were determined among 485 adult patients with definite, complicated, left-sided IE who underwent cardiac surgery during their index hospitalization. The relationship between early surgical intervention (<7 days from admission to surgery center) and outcome after surgery was analyzed. The primary end point of the study was 6-month survival. RESULTS: The median time to surgery from admission to surgical center was 7 (interquartile range 2-15) days. Patients who underwent earlier surgery were more likely transferred to the surgical center (74.2% vs 46.4%, P < .001) and had a lower percentage of preexisting heart failure (before IE diagnosis) (6.0% vs 17.3%, P < .001) but higher rate of acute heart failure (53.2% vs 38.4%, P = .001). Variables independently associated with surgery <7 days from admission were patient transfer, acute heart failure, and nonelective surgical status (C-index = 0.84), but predicted operative risk was not. Cox proportional hazards modeling with inverse probability of treatment weighting found that earlier surgery was associated with a trend toward higher 6-month mortality compared with later surgery (hazard ratio = 1.68, 95% CI 0.97-2.96; P = .065), particularly surgery within 2 days of admission or transfer. Mortality was significantly associated with operative risk and complicated IE, including Staphylococcus aureus infection and presence of abscess. CONCLUSIONS: Earlier surgery in IE is strongly associated with acute heart failure and surgical urgency. After adjustment for operative risk and IE complications, earlier surgery <7 days from admission was associated with a trend toward higher 6-month overall mortality compared with surgery later in the index hospitalization.
- 650 _2
- $a absces $x mortalita $7 D000038
- 650 _2
- $a akutní nemoc $7 D000208
- 650 _2
- $a dospělí $7 D000328
- 650 _2
- $a senioři $7 D000368
- 650 _2
- $a bakteriální endokarditida $x mortalita $x patologie $x chirurgie $7 D004697
- 650 _2
- $a ženské pohlaví $7 D005260
- 650 _2
- $a srdeční selhání $x epidemiologie $x etiologie $7 D006333
- 650 _2
- $a hospitalizace $7 D006760
- 650 _2
- $a lidé $7 D006801
- 650 _2
- $a mužské pohlaví $7 D008297
- 650 _2
- $a lidé středního věku $7 D008875
- 650 _2
- $a přemístění pacientů $x statistika a číselné údaje $7 D010360
- 650 _2
- $a tendenční skóre $7 D057216
- 650 _2
- $a proporcionální rizikové modely $7 D016016
- 650 _2
- $a prospektivní studie $7 D011446
- 650 _2
- $a rizikové faktory $7 D012307
- 650 _2
- $a stafylokokové infekce $x mortalita $7 D013203
- 650 _2
- $a Staphylococcus aureus $7 D013211
- 650 _2
- $a chirurgie operační $7 D013514
- 650 12
- $a čas zasáhnout při rozvinutí nemoci $7 D061665
- 655 _2
- $a časopisecké články $7 D016428
- 655 _2
- $a multicentrická studie $7 D016448
- 655 _2
- $a pozorovací studie $7 D064888
- 655 _2
- $a práce podpořená grantem $7 D013485
- 700 1_
- $a Chu, Vivian H $u Duke University Medical Center, Durham, NC.
- 700 1_
- $a Athan, Eugene $u Barwon Health and Deakin University, Geelong, Australia.
- 700 1_
- $a Delahaye, Francois $u Hospital Louis Pradel, Lyon-, Bron, France.
- 700 1_
- $a Freiberger, Tomas $u Centre for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic.
- 700 1_
- $a Lamas, Cristiane $u Instituto Nacional de Cardiologia and Unigranrio, Rio de Janeiro, Brazil.
- 700 1_
- $a Miro, Jose M $u Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
- 700 1_
- $a Strahilevitz, Jacob $u Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
- 700 1_
- $a Tribouilloy, Christophe $u University Hospital, Amiens, France and INSERM U-1088, University of Picardie, Amiens, France.
- 700 1_
- $a Durante-Mangoni, Emanuele $u Internal Medicine, University of Campania, Monaldi Hospital, Naples, Italy.
- 700 1_
- $a Pericas, Juan M $u Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
- 700 1_
- $a Fernández-Hidalgo, Nuria $u Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
- 700 1_
- $a Nacinovich, Francisco $u Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina.
- 700 1_
- $a Barsic, Bruno $u School of Medicine University of Zagreb, Hospital for Infectious Diseases, Zagreb, Croatia.
- 700 1_
- $a Giannitsioti, Efthymia $u Attikon University General Hospital, Athens, Greece.
- 700 1_
- $a Hurley, John P $u Mater Misericordiae University Hospital, Dublin, Ireland.
- 700 1_
- $a Hannan, Margaret M $u Mater Misericordiae University Hospital, Dublin, Ireland.
- 700 1_
- $a Park, Lawrence P $u Duke University Medical Center, Durham, NC.
- 710 2_
- $a ICE-PLUS Investigators
- 773 0_
- $w MED00000228 $t American heart journal $x 1097-6744 $g Roč. 210, č. - (2019), s. 108-116
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/30802708 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y a $z 0
- 990 __
- $a 20200109 $b ABA008
- 991 __
- $a 20200113081904 $b ABA008
- 999 __
- $a ok $b bmc $g 1483238 $s 1083642
- BAS __
- $a 3
- BAS __
- $a PreBMC
- BMC __
- $a 2019 $b 210 $c - $d 108-116 $e 20190117 $i 1097-6744 $m The American heart journal $n Am Heart J $x MED00000228
- LZP __
- $a Pubmed-20200109
