Antonio Ramos-Martínez1, Jorge Calderón-Parra2, José Mª Miró3, Patricia Muñoz4, Hugo Rodríguez-Abella5, Maricela Valerio6, Arístides de Alarcón7, Rafael Luque8, Juan Ambrosioni9, Mª Carmen Fariñas10, Miguel Ángel Goenaga11, José Antonio Oteo12, Francisco Javier Martínez Marcos13, David Vinuesa14, Fernando Domínguez15. 1. Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Universitario Puerta de Hierro, Majadahonda, Madrid, Spain. Electronic address: aramosm@salud.madrid.org. 2. Servicio de Medicina Interna, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain. 3. Servicio de Enfermedades Infecciosas, Hospital Clinic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain. Electronic address: jmmiro@clinic.ub.es. 4. Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Facultad de Medicina, Universidad Complutense de Madrid, Spain. Electronic address: pmuñoz@micro.hggm.es. 5. Servicio de Cirugía Cardiaca, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 6. Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Spain. 7. Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBIS), University of Seville/CSIC/University Virgen del Rocío and Virgen Macarena, Seville, Spain. 8. Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBIS), University of Seville/CSIC/University Virgen del Rocío and Virgen Macarena, Seville, Spain. Electronic address: rluque@luque.jazztel.es. 9. Servicio de Enfermedades Infecciosas, Hospital Clinic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain. Electronic address: ambrosioni@clinic.ub.es. 10. Infectious Diseases Unit, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain. Electronic address: mcfarinas@humv.es. 11. Servicio de Enfermedades Infecciosas, Hospital Universitario Donosti, San Sebastián, Spain. 12. Servicio de Enfermedades Infecciosas, Hospital San Pedro, Centro de Investigación Biomédica de La Rioja (CIBIR), Spain. Electronic address: jaoteo@riojasalud.es. 13. Unidad de Gestión Clínica de Enfermedades Infecciosas, Complejo Hospitalario Universitario de Huelva, Huelva, Spain. 14. Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital Clínico San Cecilio, Granada, Spain. 15. Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
Abstract
AIM: To evaluate the effect of the type of surgical indication on mortality in infective endocarditis (IE) patients who are rejected for surgery. METHODS AND RESULTS: From January 2008 to December 2016, 2714 patients with definite left-sided IE were attended in the participating hospitals. One thousand six hundred and fifty-three patients (60.9%) presented surgical indications. Five hundred and thirty-eight patients (32.5%) presented surgical indications but received medical treatment alone. The indications for surgery in these patients were uncontrolled infection (366 patients, 68%), heart failure (168 patients, 31.3%) and prevention of embolism (148 patients, 27.6%). One hundred and thirty patients (24.2%) presented more than one indication. The mortality during hospital admission was 60% (323 patients). The in-hospital mortality of patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 75.6%, 61.4% and 54.7%, respectively (p < 0.001). Surgical indications due to heart failure (OR: 3.24; CI 95%: 1.99-5.9) or uncontrolled infection (OR: 1.83; CI 95%: 1.04-3.18) were independently associated with a fatal outcome during hospital admission. Mortality during the first year was 75.4%. The mortality during the first year in patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 85.9%, 76.7% and 72.7%, respectively (p = 0.016). Surgical indication due to heart failure (OR: 3.03; CI 95%: 1.53-5.98) were independently associated with fatal outcome during the first year. CONCLUSIONS: The type of surgical indication is associated with mortality in IE patients who are rejected for surgical intervention.
AIM: To evaluate the effect of the type of surgical indication on mortality in infective endocarditis (IE) patients who are rejected for surgery. METHODS AND RESULTS: From January 2008 to December 2016, 2714 patients with definite left-sided IE were attended in the participating hospitals. One thousand six hundred and fifty-three patients (60.9%) presented surgical indications. Five hundred and thirty-eight patients (32.5%) presented surgical indications but received medical treatment alone. The indications for surgery in these patients were uncontrolled infection (366 patients, 68%), heart failure (168 patients, 31.3%) and prevention of embolism (148 patients, 27.6%). One hundred and thirty patients (24.2%) presented more than one indication. The mortality during hospital admission was 60% (323 patients). The in-hospital mortality of patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 75.6%, 61.4% and 54.7%, respectively (p < 0.001). Surgical indications due to heart failure (OR: 3.24; CI 95%: 1.99-5.9) or uncontrolled infection (OR: 1.83; CI 95%: 1.04-3.18) were independently associated with a fatal outcome during hospital admission. Mortality during the first year was 75.4%. The mortality during the first year in patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 85.9%, 76.7% and 72.7%, respectively (p = 0.016). Surgical indication due to heart failure (OR: 3.03; CI 95%: 1.53-5.98) were independently associated with fatal outcome during the first year. CONCLUSIONS: The type of surgical indication is associated with mortality in IE patients who are rejected for surgical intervention.
Authors: P Fillâtre; A Gacouin; M Revest; A Maamar; S Patrat-Delon; E Flécher; O Fouquet; N Lerolle; J-P Verhoye; Y Le Tulzo; Pierre Tattevin; J-M Tadié Journal: Eur J Clin Microbiol Infect Dis Date: 2019-11-26 Impact factor: 3.267
Authors: Amber Bux; Ahmad Mustafa; Muhammad Niazi; Umesh Manchandani; Neville Mobarakai; James Lafferty; Vincent DeChavez Journal: IDCases Date: 2022-01-28
Authors: Jorge Calderón-Parra; Itziar Diego-Yagüe; Beatriz Santamarina-Alcantud; Susana Mingo-Santos; Alberto Mora-Vargas; José Manuel Vázquez-Comendador; Ana Fernández-Cruz; Elena Muñez-Rubio; Andrea Gutiérrez-Villanueva; Isabel Sánchez-Romero; Antonio Ramos-Martínez Journal: J Clin Med Date: 2022-03-09 Impact factor: 4.241