Association between surgical indications, operative risk, and clinical outcome in infective endocarditis: a prospective study from the International Collaboration on Endocarditis
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu srovnávací studie, časopisecké články, multicentrická studie, práce podpořená grantem
PubMed
25480814
DOI
10.1161/circulationaha.114.012461
PII: CIRCULATIONAHA.114.012461
Knihovny.cz E-zdroje
- Klíčová slova
- endocarditis, infection, mortality, surgery, valve,
- MeSH
- absces epidemiologie MeSH
- antiinfekční látky terapeutické užití MeSH
- bakteriemie farmakoterapie epidemiologie MeSH
- chirurgická náhrada chlopně statistika a číselné údaje MeSH
- embolie etiologie MeSH
- endokarditida farmakoterapie mortalita chirurgie MeSH
- hodnocení rizik MeSH
- infekce spojené se zdravotní péčí farmakoterapie mortalita chirurgie MeSH
- Kaplanův-Meierův odhad MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- pooperační komplikace epidemiologie MeSH
- prognóza MeSH
- prospektivní studie MeSH
- senioři MeSH
- srdeční chlopně mikrobiologie chirurgie MeSH
- stafylokokové infekce farmakoterapie mortalita MeSH
- stupeň závažnosti nemoci MeSH
- teoretické modely MeSH
- výběr pacientů MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Názvy látek
- antiinfekční látky MeSH
BACKGROUND: Use of surgery for the treatment of infective endocarditis (IE) as related to surgical indications and operative risk for mortality has not been well defined. METHODS AND RESULTS: The International Collaboration on Endocarditis-PLUS (ICE-PLUS) is a prospective cohort of consecutively enrolled patients with definite IE from 29 centers in 16 countries. We included patients from ICE-PLUS with definite left-sided, non-cardiac device-related IE who were enrolled between September 1, 2008, and December 31, 2012. A total of 1296 patients with left-sided IE were included. Surgical treatment was performed in 57% of the overall cohort and in 76% of patients with a surgical indication. Reasons for nonsurgical treatment included poor prognosis (33.7%), hemodynamic instability (19.8%), death before surgery (23.3%), stroke (22.7%), and sepsis (21%). Among patients with a surgical indication, surgical treatment was independently associated with the presence of severe aortic regurgitation, abscess, embolization before surgical treatment, and transfer from an outside hospital. Variables associated with nonsurgical treatment were a history of moderate/severe liver disease, stroke before surgical decision, and Staphyloccus aureus etiology. The integration of surgical indication, Society of Thoracic Surgeons IE score, and use of surgery was associated with 6-month survival in IE. CONCLUSIONS: Surgical decision making in IE is largely consistent with established guidelines, although nearly one quarter of patients with surgical indications do not undergo surgery. Operative risk assessment by Society of Thoracic Surgeons IE score provides prognostic information for survival beyond the operative period. S aureus IE was significantly associated with nonsurgical management.
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