The hidden side of infective endocarditis : Diagnostic and management of 500 consecutive cases in noncardiac surgery centers (2009-2018)
Copyright © 2023 Elsevier Inc. All rights reserved..
BACKGROUND: We aimed to describe infective endocarditis cases from noncardiac surgery centers, as current knowledge on infective endocarditis is derived mostly from cardiac surgery hospitals.
METHODS: An observational retrospective study (2009-2018) was conducted in 9 noncardiac surgery hospitals in Central Catalonia. All adult patients diagnosed with definitive infective endocarditis were included. Transferred and nontransferred cohorts were compared, and a logistic regression model was used to ascertain the prognostic factors.
RESULTS: Overall, 502 infective endocarditis episodes were included: 183 (36.5%) were transferred to the cardiac surgery center, whereas 319 were not, with (18.7%) and without (45%) surgical indications. Cardiac surgery was performed in 83% of transferred patients. In-hospital (14% vs 23%) and 1-year (20% vs 35%) mortality rates were significantly lower in transferred patients (P < .001). Among the patients not undergoing cardiac surgery despite an indication, 55 (54%) died within 1 year. The multivariate analysis identified the following independent predictive factors for in-hospital mortality: Staphylococcus aureus infective endocarditis (odds ratio: 1.93 [1.08, 3.47]), heart failure (odds ratio: 3.87 [2.28, 6.57]), central nervous system embolism (odds ratio: 2.95 [1.41, 5.14]), and Charlson score (odds ratio: 1.19 [1.09, 1.30]), whereas community acquisition (odds ratio: 0.52 [0.29, 0.93]), cardiac surgery (odds ratio: 0.42 [0.20, 0.87]), but not transfer (odds ratio: 1.23 [0.84, 3.95]) were identified as protective factors. One-year mortality was associated with S. aureus infective endocarditis (odds ratio: 1.82 [1.04, 3.18]), heart failure (odds ratio: 3.74 [2.27, 6.16]), and Charlson score (odds ratio: 1.23 [1.13, 1.33]), whereas cardiac surgery (odds ratio: 0.41 [0.21, 0.79]) was identified as a protective factor.
CONCLUSION: Patients not transferred to a referral cardiac surgery center have a worse prognosis compared to those ultimately transferred, as cardiac surgery is associated with lower mortality rates.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:174 |
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| Enthalten in: |
Surgery - 174(2023), 3 vom: 13. Sept., Seite 602-610 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Calzado, Sonia [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 08.08.2023 Date Revised 08.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.surg.2023.04.061 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM358234743 |
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| 100 | 1 | |a Calzado, Sonia |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The hidden side of infective endocarditis |b Diagnostic and management of 500 consecutive cases in noncardiac surgery centers (2009-2018) |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 08.08.2023 | ||
| 500 | |a Date Revised 08.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: We aimed to describe infective endocarditis cases from noncardiac surgery centers, as current knowledge on infective endocarditis is derived mostly from cardiac surgery hospitals | ||
| 520 | |a METHODS: An observational retrospective study (2009-2018) was conducted in 9 noncardiac surgery hospitals in Central Catalonia. All adult patients diagnosed with definitive infective endocarditis were included. Transferred and nontransferred cohorts were compared, and a logistic regression model was used to ascertain the prognostic factors | ||
| 520 | |a RESULTS: Overall, 502 infective endocarditis episodes were included: 183 (36.5%) were transferred to the cardiac surgery center, whereas 319 were not, with (18.7%) and without (45%) surgical indications. Cardiac surgery was performed in 83% of transferred patients. In-hospital (14% vs 23%) and 1-year (20% vs 35%) mortality rates were significantly lower in transferred patients (P < .001). Among the patients not undergoing cardiac surgery despite an indication, 55 (54%) died within 1 year. The multivariate analysis identified the following independent predictive factors for in-hospital mortality: Staphylococcus aureus infective endocarditis (odds ratio: 1.93 [1.08, 3.47]), heart failure (odds ratio: 3.87 [2.28, 6.57]), central nervous system embolism (odds ratio: 2.95 [1.41, 5.14]), and Charlson score (odds ratio: 1.19 [1.09, 1.30]), whereas community acquisition (odds ratio: 0.52 [0.29, 0.93]), cardiac surgery (odds ratio: 0.42 [0.20, 0.87]), but not transfer (odds ratio: 1.23 [0.84, 3.95]) were identified as protective factors. One-year mortality was associated with S. aureus infective endocarditis (odds ratio: 1.82 [1.04, 3.18]), heart failure (odds ratio: 3.74 [2.27, 6.16]), and Charlson score (odds ratio: 1.23 [1.13, 1.33]), whereas cardiac surgery (odds ratio: 0.41 [0.21, 0.79]) was identified as a protective factor | ||
| 520 | |a CONCLUSION: Patients not transferred to a referral cardiac surgery center have a worse prognosis compared to those ultimately transferred, as cardiac surgery is associated with lower mortality rates | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Hernández-Meneses, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Llopis, Jaume |e verfasserin |4 aut | |
| 700 | 1 | |a Boix-Palop, Lucía |e verfasserin |4 aut | |
| 700 | 1 | |a Dietl, Beatriz |e verfasserin |4 aut | |
| 700 | 1 | |a Calbo, Esther |e verfasserin |4 aut | |
| 700 | 1 | |a Andrés, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a García, Xelo |e verfasserin |4 aut | |
| 700 | 1 | |a Agustí, Carme |e verfasserin |4 aut | |
| 700 | 1 | |a Dorca, Esther |e verfasserin |4 aut | |
| 700 | 1 | |a Tricas, José M |e verfasserin |4 aut | |
| 700 | 1 | |a Díez de Los Ríos, Javier |e verfasserin |4 aut | |
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| 700 | 1 | |a Ortiz, María |e verfasserin |4 aut | |
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| 700 | 1 | |a Guillamon, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Quintana, Eduard |e verfasserin |4 aut | |
| 700 | 1 | |a Ambrosioni, Juan |e verfasserin |4 aut | |
| 700 | 1 | |a Gasch, Oriol |e verfasserin |4 aut | |
| 700 | 1 | |a Miró, José M |e verfasserin |4 aut | |
| 700 | 0 | |a Central Catalonia 10 Endocarditis Teams (CC10ET) |e verfasserin |4 aut | |
| 700 | 1 | |a Miró, Jose M |e investigator |4 oth | |
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