Analysis of Short- and Long-term Outcomes of Patients With Surgically Treated Left-sided Infective Endocarditis: A 5-Year Longitudinal Follow-up Study

Autor: Brett Hiebert, Oksana Marushchak, Holy Cole, Rakesh C. Arora, Pallav Shah, Evelyn Lo, James W. Tam, Nasir Shaikh, Alan H. Menkis, Yoav Keynan
Rok vydání: 2017
Předmět:
Adult
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Prosthesis-Related Infections
Time Factors
Databases
Factual
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Patient Readmission
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Risk Factors
Long term outcomes
Left sided infective endocarditis
Humans
Medicine
Endocarditis
Hospital Mortality
Longitudinal Studies
Aged
Proportional Hazards Models
Retrospective Studies
Heart Valve Prosthesis Implantation
Culture-negative endocarditis
Native Valve Endocarditis
biology
business.industry
Follow up studies
Manitoba
Endocarditis
Bacterial
General Medicine
Middle Aged
medicine.disease
biology.organism_classification
Surgery
Logistic Models
Treatment Outcome
030228 respiratory system
Viridans streptococci
Heart Valve Prosthesis
Infective endocarditis
Multivariate Analysis
Female
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: Seminars in Thoracic and Cardiovascular Surgery. 29:311-320
ISSN: 1043-0679
Popis: This study aims to analyze survival, repeat hospitalization, and risk factors for surgically treated left-sided endocarditis. Retrospective review of all 166 (114 native and 52 prosthetic) patients operated between January 2004 and March 2015 was performed. Long-term survival and repeat hospitalization data for 134 of 166 patients were obtained via linked clinical databases with the Manitoba Centre for Health Policy. Kaplan-Meier estimates of survival and hospital readmission and Cox multivariable regression analysis of factors influencing outcomes were performed. Survival at 1 and 5 years was 91% and 80%, respectively, and major adverse prosthesis-related event repeat hospitalization rates were 12% and 21%, respectively. Repeat hospitalization because of endocarditis was 7% and 11% at 1 and 5 years, respectively. Survival and repeat hospitalization were similar for aortic and mitral valves. Survival after surgically treated endocarditis was similar to survival for age-, sex-, and valve-matched surgical valve replacements for noninfectious indications (P = 0.53). Viridans Streptococci was the most common organism in native valve endocarditis, and culture negative endocarditis was most common in prosthetic valves. Prosthetic valve endocarditis (P 0.01) and preoperative renal dysfunction (P 0.01) were risk factors for in-hospital mortality and major postoperative adverse events. Diabetes and renal dysfunction were associated with poor long-term survival, functional survival, and repeat hospitalization. This analysis suggests that surgery remains a very effective tool in management of these complex patients in terms of survival and major adverse prosthesis-related event repeat hospitalization.
Databáze: OpenAIRE
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