Bernard Iung1, Thanh Doco-Lecompte2, Sidney Chocron3, Christophe Strady4, François Delahaye5, Vincent Le Moing6, Claire Poyart7, François Alla8, Emmanuelle Cambau9, Pierre Tattevin10, Catherine Chirouze11, Jean-François Obadia12, Xavier Duval13, Bruno Hoen14. 1. Département de Cardiologie, AP-HP, Hôpital Bichat, Université Paris-Diderot, DHU Fire, 46 rue Henri Huchard, 75018 Paris, France bernard.iung@bch.aphp.fr. 2. Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Genève, Geneve, Switzerland. 3. Service de Chirurgie Cardiaque, Centre Hospitalier Universitaire, Besançon, France. 4. Cabinet d'Infectiologie. Clinique Saint André-Groupe Courlancy, Reims, France. 5. Hôpital Louis Pradel, Hospices Civils de Lyon, Université Claude Bernard, Lyon, France. 6. Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional Universitaire de Montpellier, Montpellier, France Unité Mixte de Recherche 145 Institut de Recherche sur le Développement/Université Montpellier 1, Montpellier, France. 7. AP-HP, Service de Bactériologie, Centre National de Référence des Streptocoques (CNR-Strep), Hôpital Cochin, Paris, France Institut Cochin, Université Paris Descartes, Faculté de médecine, CNRS (UMR 8104), Paris, France Inserm, U1016, Paris, France. 8. EA 4003, Université de Nancy, Nancy, France Inserm CIC 007, Nancy, France. 9. AP-HP, Hôpital Lariboisière, Service de Bactériologie, Paris, France Université Paris Diderot, Sorbonne Paris Cité, IAME UMR1137, Paris, France. 10. Unité de Soins Intensifs et de Maladies Infectieuses, Hôpital Universitaire Pontchaillou, Rennes, France. 11. Maladies Infectieuses et Tropicales. Centre Hospitalier Universitaire, Besançon, France. 12. Hôpital Louis Pradel, Lyon, Chirurgie Cardiothoracique et Transplantation, Bron, France. 13. AP-HP, Centre d'Investigation Clinique Inserm 1425, Hôpital Bichat, Université Paris-Diderot, Inserm U1137, Paris, France. 14. Université des Antilles et de la Guyane, Faculté de Médecine Hyacinthe Bastaraud, EA 4537, Pointe-à-Pitre, France Centre Hospitalier Universitaire de Pointe-à-Pitre, Inserm CIC1424, Service de Maladies Infectieuses et Tropicales, Dermatologie, Médecine Interne, Pointe-à-Pitre, France.
Abstract
AIMS: Indications for surgery in acute infective endocarditis (IE) are detailed in guidelines, but their application is not well known. We analysed the agreement between the patient's attending physicians and European Society of Cardiology guidelines regarding indications for surgery. We also assessed whether surgery was performed in patients who had an indication. METHODS AND RESULTS: From the 2008 prospective population-based French survey on IE, 303 patients with definite left-sided native IE were identified. For each case, we prospectively recorded (i) indication for surgery according to the attending physicians and (ii) indication for surgery according to guidelines. Surgery was indicated in 194 (65%) patients according to attending physicians and in 221 (73%) according to guidelines, while 139 (46%) underwent surgery. Agreement was moderate between attending physicians and guidelines (kappa 0.41-0.59) and between indication according to guidelines and the performance of surgery (kappa 0.38). Of the 90 (30%) patients not operated despite indication, contraindication to surgery was reported by the attending physicians in 42 (47%), and indication was not identified in 48 (53%). One-year survival was 76% in patients with indication and surgery performed (n = 131), 69% in patients without indication and no surgery (n = 74), 56% in patients with identified indication and contraindication to surgery (n = 42), and 60% in patients with no identified indication (n = 48; P = 0.059). CONCLUSION: Cardiac surgery during acute IE was recommended in almost three out of four patients, although fewer than half were actually operated. Indication was not acknowledged by the attending physicians in one out of six patients. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Indications for surgery in acute infective endocarditis (IE) are detailed in guidelines, but their application is not well known. We analysed the agreement between the patient's attending physicians and European Society of Cardiology guidelines regarding indications for surgery. We also assessed whether surgery was performed in patients who had an indication. METHODS AND RESULTS: From the 2008 prospective population-based French survey on IE, 303 patients with definite left-sided native IE were identified. For each case, we prospectively recorded (i) indication for surgery according to the attending physicians and (ii) indication for surgery according to guidelines. Surgery was indicated in 194 (65%) patients according to attending physicians and in 221 (73%) according to guidelines, while 139 (46%) underwent surgery. Agreement was moderate between attending physicians and guidelines (kappa 0.41-0.59) and between indication according to guidelines and the performance of surgery (kappa 0.38). Of the 90 (30%) patients not operated despite indication, contraindication to surgery was reported by the attending physicians in 42 (47%), and indication was not identified in 48 (53%). One-year survival was 76% in patients with indication and surgery performed (n = 131), 69% in patients without indication and no surgery (n = 74), 56% in patients with identified indication and contraindication to surgery (n = 42), and 60% in patients with no identified indication (n = 48; P = 0.059). CONCLUSION: Cardiac surgery during acute IE was recommended in almost three out of four patients, although fewer than half were actually operated. Indication was not acknowledged by the attending physicians in one out of six patients. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Elisabeth Fernandes; Claude Olive; Jocelyn Inamo; François Roques; André Cabié; Patrick Hochedez Journal: Am J Trop Med Hyg Date: 2017-07 Impact factor: 2.345
Authors: Mahbub Jamil; Ibrahim Sultan; Thomas G Gleason; Forozan Navid; Michael A Fallert; Matthew S Suffoletto; Arman Kilic Journal: J Thorac Dis Date: 2019-11 Impact factor: 2.895
Authors: John A Woller Iii; Victoria L Walsh; Chad Robichaux; Vinod H Thourani; Jesse T Jacob Journal: Open Forum Infect Dis Date: 2018-10-20 Impact factor: 3.835