J 2019

Association between the timing of surgery for complicated, left-sided infective endocarditis and survival

WANG, A., VH CHU, E. ATHAN, F. DELAHAYE, Tomáš FREIBERGER et. al.

Základní údaje

Originální název

Association between the timing of surgery for complicated, left-sided infective endocarditis and survival

Autoři

WANG, A. (840 Spojené státy), VH CHU (36 Austrálie), E. ATHAN (36 Austrálie), F. DELAHAYE (250 Francie), Tomáš FREIBERGER (203 Česká republika, garant, domácí), C. LAMAS (76 Brazílie), J.M. MIRO (724 Španělsko), J. STRAHILEVITZ (376 Izrael), C. TRIBOUILLOY (250 Francie), E. DURANTE-MANGONI (380 Itálie), J.M. PERICAS (724 Španělsko), N. FERNANDEZ-HIDALGO (724 Španělsko), F. NACINOVICH (32 Argentina), B. BARSIC (191 Chorvatsko), E. GIANNITSIOTI (300 Řecko), J.P. HURLEY (372 Irsko), M.M. HANNAN (372 Irsko) a L.P. PARK (840 Spojené státy)

Vydání

American Heart Journal, New York, Mosby Inc. 2019, 0002-8703

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 4.153

Kód RIV

RIV/00216224:14740/19:00109677

Organizační jednotka

Středoevropský technologický institut

UT WoS

000462587600013

Klíčová slova anglicky

NATIVE VALVE ENDOCARDITIS; ANTIMICROBIAL THERAPY; 6-MONTH MORTALITY; CARDIAC-SURGERY; REFERRAL BIAS; IMPACT; MANAGEMENT; ADULTS; RISK; GUIDELINES

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 31. 3. 2020 21:22, Mgr. Pavla Foltynová, Ph.D.

Anotace

V originále

Background In patients with active infective endocarditis (IE), the relationship between timing of surgery and survival is uncertain. The objective was to evaluate clinical characteristics associated with timing of surgery and the association between surgical timing and 6-month survival in complicated, left-sided IE. Methods In a prospective, multicenter, observational registry (The International Collaboration on Endocarditis-PLUS, registry from 2008 to 2012), clinical factors associated with timing of surgery during the index hospitalization were determined among 485 adult patients with definite, complicated, left-sided IE who underwent cardiac surgery during their index hospitalization. The relationship between early surgical intervention (<7 days from admission to surgery center) and outcome after surgery was analyzed. The primary end point of the study was 6-month survival. Results The median time to surgery from admission to surgical center was 7 (interquartile range 2-15) days. Patients who underwent earlier surgery were more likely transferred to the surgical center (74.2% vs 46.4%, P < .001) and had a lower percentage of preexisting heart failure (before IE diagnosis) (6.0% vs 17.3%, P < .001) but higher rate of acute heart failure (53.2% vs 38.4%, P = .001). Variables independently associated with surgery <7 days from admission were patient transfer, acute heart failure, and nonelective surgical status (C-index = 0.84), but predicted operative risk was not. Cox proportional hazards modeling with inverse probability of treatment weighting found that earlier surgery was associated with a trend toward higher 6-month mortality compared with later surgery (hazard ratio = 1.68, 95% CI 0.97-2.96; P = .065), particularly surgery with in 2 days of admission or transfer. Mortality was significantly associated with operative risk and complicated IE, including Staphylococcus aureus infection and presence of abscess. Conclusions Earlier surgery in IE is strongly associated with acute heart failure and surgical urgency. After adjustment for operative risk and IE complications, earlier surgery <7 days from admission was associated with a trend toward higher 6-month overall mortality compared with surgery later in the index hospitalization.