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@article{1531676,
author = {Wang, A. and Chu, VH and Athan, E. and Delahaye, F. and Freiberger, Tomáš and Lamas, C. and Miro, J.M. and Strahilevitz, J. and Tribouilloy, C. and DuranteandMangoni, E. and Pericas, J.M. and FernandezandHidalgo, N. and Nacinovich, F. and Barsic, B. and Giannitsioti, E. and Hurley, J.P. and Hannan, M.M. and Park, L.P.},
article_location = {New York},
article_number = {APR},
doi = {http://dx.doi.org/10.1016/j.ahj.2019.01.004},
keywords = {NATIVE VALVE ENDOCARDITIS; ANTIMICROBIAL THERAPY; 6-MONTH MORTALITY; CARDIAC-SURGERY; REFERRAL BIAS; IMPACT; MANAGEMENT; ADULTS; RISK; GUIDELINES},
language = {eng},
issn = {0002-8703},
journal = {American Heart Journal},
title = {Association between the timing of surgery for complicated, left-sided infective endocarditis and survival},
url = {https://www.sciencedirect.com/science/article/pii/S0002870319300055?via%3Dihub},
volume = {210},
year = {2019}
}
TY - JOUR
ID - 1531676
AU - Wang, A. - Chu, VH - Athan, E. - Delahaye, F. - Freiberger, Tomáš - Lamas, C. - Miro, J.M. - Strahilevitz, J. - Tribouilloy, C. - Durante-Mangoni, E. - Pericas, J.M. - Fernandez-Hidalgo, N. - Nacinovich, F. - Barsic, B. - Giannitsioti, E. - Hurley, J.P. - Hannan, M.M. - Park, L.P.
PY - 2019
TI - Association between the timing of surgery for complicated, left-sided infective endocarditis and survival
JF - American Heart Journal
VL - 210
IS - APR
SP - 108-116
EP - 108-116
PB - Mosby Inc.
SN - 00028703
KW - NATIVE VALVE ENDOCARDITIS
KW - ANTIMICROBIAL THERAPY
KW - 6-MONTH MORTALITY
KW - CARDIAC-SURGERY
KW - REFERRAL BIAS
KW - IMPACT
KW - MANAGEMENT
KW - ADULTS
KW - RISK
KW - GUIDELINES
UR - https://www.sciencedirect.com/science/article/pii/S0002870319300055?via%3Dihub
L2 - https://www.sciencedirect.com/science/article/pii/S0002870319300055?via%3Dihub
N2 - 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.
ER -
WANG, A., VH CHU, E. ATHAN, F. DELAHAYE, Tomáš FREIBERGER, C. LAMAS, J.M. MIRO, J. STRAHILEVITZ, C. TRIBOUILLOY, E. DURANTE-MANGONI, J.M. PERICAS, N. FERNANDEZ-HIDALGO, F. NACINOVICH, B. BARSIC, E. GIANNITSIOTI, J.P. HURLEY, M.M. HANNAN a L.P. PARK. Association between the timing of surgery for complicated, left-sided infective endocarditis and survival. \textit{American Heart Journal}. New York: Mosby Inc., 2019, roč.~210, APR, s.~108-116. ISSN~0002-8703. Dostupné z: https://dx.doi.org/10.1016/j.ahj.2019.01.004.
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