Effect of the type of surgical indication on mortality in patients with infective endocarditis who are rejected for surgical intervention.
Int J Cardiol
; 282: 24-30, 2019 May 01.
Article
en En
| MEDLINE
| ID: mdl-30718134
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 ANDRESULTS:
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 (pâ¯<â¯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 (pâ¯=â¯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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Endocarditis Bacteriana
/
Procedimientos Quirúrgicos Cardíacos
Tipo de estudio:
Observational_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Int J Cardiol
Año:
2019
Tipo del documento:
Article