Lauge Østergaard1, Louise Bruun Oestergaard2,3,4, Trine Kiilerich Lauridsen2, Anders Dahl2,5, Mavish Chaudry2, Gunnar Gislason2,6, Christian Torp-Pedersen3,4, Niels Eske Bruun7,8,9, Nana Valeur5, Lars Køber1, Emil Loldrup Fosbøl1. 1. Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen, Denmark. 2. Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark. 3. Department of Clinical Epidemiology, University of Aalborg, Aalborg, Denmark. 4. Department of Cardiology, University of Aalborg, Aalborg, Denmark. 5. Department of Cardiology, Bispebjerg Hospital, Copenhagen, Denmark. 6. The Danish Heart Foundation, Copenhagen, Denmark. 7. Clinical Institute, Copenhagen University, Copenhagen, Denmark. 8. Department of Cardiology, Roskilde University Hospital, Roskilde, Denmark. 9. Clinical Institute, Aalborg University, Aalborg, Denmark.
Abstract
OBJECTIVES: It is known that patients surviving infective endocarditis have a poor long-term prognosis; however, few studies have addressed the long-term causes of death in patients surviving the initial hospitalization. METHODS: Using Danish administrative registries, we identified patients admitted to a hospital with 1st time infective endocarditis in the period from January 1996 to December 2014, who were alive at the time of discharge. The study population was categorized into (i) patients undergoing medical therapy only and (ii) patients undergoing surgical and medical treatment. We examined the cardiovascular and non-cardiovascular causes of death. Using the Cox analysis, we investigated the associated risk of dying from a specific prespecified cause of death (heart failure, infective endocarditis and stroke) within the surgery group when compared with the medically treated group. RESULTS: We identified 5576 patients: 4220 patients belonged to the medically treated group and 1356 patients to the surgery group. At the 10-year follow-up, the mortality rate was 63.1% and 41.6% in the medically treated group and the surgery group, respectively. Cardiovascular disease was the most frequent cause of death in both groups accounting for 52.5% in the medically treated group and 55.2% in the surgery group. Patients undergoing surgery were associated with a lower risk of dying from heart failure and stroke when compared with medically treated patients [hazard ratio = 0.66 (95% confidence interval: 0.46-0.94) and hazard ratio = 0.59 (95% confidence interval: 0.37-0.96), respectively]. CONCLUSIONS: No major differences were found in the main causes of death between groups. Patients in the surgical group were associated with a lower risk of dying from heart failure and stroke when compared with medically treated patients.
OBJECTIVES: It is known that patients surviving infective endocarditis have a poor long-term prognosis; however, few studies have addressed the long-term causes of death in patients surviving the initial hospitalization. METHODS: Using Danish administrative registries, we identified patients admitted to a hospital with 1st time infective endocarditis in the period from January 1996 to December 2014, who were alive at the time of discharge. The study population was categorized into (i) patients undergoing medical therapy only and (ii) patients undergoing surgical and medical treatment. We examined the cardiovascular and non-cardiovascular causes of death. Using the Cox analysis, we investigated the associated risk of dying from a specific prespecified cause of death (heart failure, infective endocarditis and stroke) within the surgery group when compared with the medically treated group. RESULTS: We identified 5576 patients: 4220 patients belonged to the medically treated group and 1356 patients to the surgery group. At the 10-year follow-up, the mortality rate was 63.1% and 41.6% in the medically treated group and the surgery group, respectively. Cardiovascular disease was the most frequent cause of death in both groups accounting for 52.5% in the medically treated group and 55.2% in the surgery group. Patients undergoing surgery were associated with a lower risk of dying from heart failure and stroke when compared with medically treated patients [hazard ratio = 0.66 (95% confidence interval: 0.46-0.94) and hazard ratio = 0.59 (95% confidence interval: 0.37-0.96), respectively]. CONCLUSIONS: No major differences were found in the main causes of death between groups. Patients in the surgical group were associated with a lower risk of dying from heart failure and stroke when compared with medically treated patients.
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Authors: S Sunder; L Grammatico-Guillon; A Lemaignen; M Lacasse; C Gaborit; D Boutoille; P Tattevin; E Denes; T Guimard; M Dupont; L Fauchier; L Bernard Journal: PLoS One Date: 2019-10-25 Impact factor: 3.240