Excess mortality and morbidity in patients surviving infective endocarditis
Background Mortality and morbidity associated with infective endocarditis may extend beyond successful treatment. The primary objective was to analyze rates, temporal changes, and predictors of excess mortality in patients surviving the acute phase of endocarditis. The secondary objective was to det...
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| Veröffentlicht in: | The American heart journal 2012-07, Vol.164 (1), p.94-101 |
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| creator | Thuny, Franck, MD, PhD Giorgi, Roch, MD, PhD Habachi, Raja, MD Ansaldi, Sebastien, MD Le Dolley, Yvan, MD Casalta, Jean-Paul, MD Avierinos, Jean-François, MD Riberi, Alberto, MD Renard, Sebastien, MD Collart, Frederic, MD Raoult, Didier, MD, PhD Habib, Gilbert, MD |
| description | Background Mortality and morbidity associated with infective endocarditis may extend beyond successful treatment. The primary objective was to analyze rates, temporal changes, and predictors of excess mortality in patients surviving the acute phase of endocarditis. The secondary objective was to determine the rate of recurrence and the need for late cardiac surgery. Methods An observational cohort study was conducted at a university-affiliated tertiary medical center, among 328 patients who survived the active phase of endocarditis. We used age-, sex-, and calendar year–specific mortality hazard rates of the Bouches-du-Rhone French district population to calculate expected survival and excess mortality. The risk of recurrence and late valve surgery was also assessed. Result Compared with expected survival, patients surviving a first episode of endocarditis had significantly worse outcomes ( P = .001). The relative survival rates at 1, 3, and 5 years were 92% (95% CI, 88%-95%), 86% (95% CI, 77%-92%), and 82% (95% CI, 59%-91%), respectively. This excess mortality was observed during the entire follow-up period but was the highest during the first year after hospital discharge. Most of the recurrences and late cardiac surgeries also occurred during this period. Women exhibited a higher risk of age-adjusted excess mortality (adjusted excess hazard ratio, 2.0; 95% CI, 1.05-3.82; P = .03). Comorbidity index, recurrence of endocarditis, and history of an aortic valve endocarditis in women were independent predictors of excess mortality. Conclusions These results justify close monitoring of patients after successful treatment of endocarditis, at least during the first year. Special attention should be paid to women with aortic valve damage. |
| doi_str_mv | 10.1016/j.ahj.2012.04.003 |
| format | Article |
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The primary objective was to analyze rates, temporal changes, and predictors of excess mortality in patients surviving the acute phase of endocarditis. The secondary objective was to determine the rate of recurrence and the need for late cardiac surgery. Methods An observational cohort study was conducted at a university-affiliated tertiary medical center, among 328 patients who survived the active phase of endocarditis. We used age-, sex-, and calendar year–specific mortality hazard rates of the Bouches-du-Rhone French district population to calculate expected survival and excess mortality. The risk of recurrence and late valve surgery was also assessed. Result Compared with expected survival, patients surviving a first episode of endocarditis had significantly worse outcomes ( P = .001). The relative survival rates at 1, 3, and 5 years were 92% (95% CI, 88%-95%), 86% (95% CI, 77%-92%), and 82% (95% CI, 59%-91%), respectively. This excess mortality was observed during the entire follow-up period but was the highest during the first year after hospital discharge. Most of the recurrences and late cardiac surgeries also occurred during this period. Women exhibited a higher risk of age-adjusted excess mortality (adjusted excess hazard ratio, 2.0; 95% CI, 1.05-3.82; P = .03). Comorbidity index, recurrence of endocarditis, and history of an aortic valve endocarditis in women were independent predictors of excess mortality. Conclusions These results justify close monitoring of patients after successful treatment of endocarditis, at least during the first year. Special attention should be paid to women with aortic valve damage.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2012.04.003</identifier><identifier>PMID: 22795288</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Age ; Biological and medical sciences ; Calendars ; Cardiology. Vascular system ; Cardiovascular ; Cohort Studies ; Comorbidity ; Drug therapy ; Endocardial and cardiac valvular diseases ; Endocarditis, Bacterial - complications ; Endocarditis, Bacterial - mortality ; Endocarditis, Bacterial - surgery ; Female ; Generalized linear models ; Heart ; Heart failure ; Heart surgery ; Hospitalization ; Humans ; Infections ; Male ; Medical prognosis ; Medical sciences ; Middle Aged ; Mortality ; Population ; Prognosis ; Prospective Studies ; Recurrence ; Studies ; Survival Rate</subject><ispartof>The American heart journal, 2012-07, Vol.164 (1), p.94-101</ispartof><rights>Mosby, Inc.</rights><rights>2012 Mosby, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Mosby, Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Jul 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c532t-f6c19965aa7c09f50ef4b6edf231bcfc6cf4bc75c4d7d31dadc736b79700248f3</citedby><cites>FETCH-LOGICAL-c532t-f6c19965aa7c09f50ef4b6edf231bcfc6cf4bc75c4d7d31dadc736b79700248f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1504638430?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,782,786,3552,27931,27932,46002,64392,64394,64396,72476</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26185025$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22795288$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thuny, Franck, MD, PhD</creatorcontrib><creatorcontrib>Giorgi, Roch, MD, PhD</creatorcontrib><creatorcontrib>Habachi, Raja, MD</creatorcontrib><creatorcontrib>Ansaldi, Sebastien, MD</creatorcontrib><creatorcontrib>Le Dolley, Yvan, MD</creatorcontrib><creatorcontrib>Casalta, Jean-Paul, MD</creatorcontrib><creatorcontrib>Avierinos, Jean-François, MD</creatorcontrib><creatorcontrib>Riberi, Alberto, MD</creatorcontrib><creatorcontrib>Renard, Sebastien, MD</creatorcontrib><creatorcontrib>Collart, Frederic, MD</creatorcontrib><creatorcontrib>Raoult, Didier, MD, PhD</creatorcontrib><creatorcontrib>Habib, Gilbert, MD</creatorcontrib><title>Excess mortality and morbidity in patients surviving infective endocarditis</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background Mortality and morbidity associated with infective endocarditis may extend beyond successful treatment. The primary objective was to analyze rates, temporal changes, and predictors of excess mortality in patients surviving the acute phase of endocarditis. The secondary objective was to determine the rate of recurrence and the need for late cardiac surgery. Methods An observational cohort study was conducted at a university-affiliated tertiary medical center, among 328 patients who survived the active phase of endocarditis. We used age-, sex-, and calendar year–specific mortality hazard rates of the Bouches-du-Rhone French district population to calculate expected survival and excess mortality. The risk of recurrence and late valve surgery was also assessed. Result Compared with expected survival, patients surviving a first episode of endocarditis had significantly worse outcomes ( P = .001). The relative survival rates at 1, 3, and 5 years were 92% (95% CI, 88%-95%), 86% (95% CI, 77%-92%), and 82% (95% CI, 59%-91%), respectively. This excess mortality was observed during the entire follow-up period but was the highest during the first year after hospital discharge. Most of the recurrences and late cardiac surgeries also occurred during this period. Women exhibited a higher risk of age-adjusted excess mortality (adjusted excess hazard ratio, 2.0; 95% CI, 1.05-3.82; P = .03). Comorbidity index, recurrence of endocarditis, and history of an aortic valve endocarditis in women were independent predictors of excess mortality. Conclusions These results justify close monitoring of patients after successful treatment of endocarditis, at least during the first year. Special attention should be paid to women with aortic valve damage.</description><subject>Age</subject><subject>Biological and medical sciences</subject><subject>Calendars</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Drug therapy</subject><subject>Endocardial and cardiac valvular diseases</subject><subject>Endocarditis, Bacterial - complications</subject><subject>Endocarditis, Bacterial - mortality</subject><subject>Endocarditis, Bacterial - surgery</subject><subject>Female</subject><subject>Generalized linear models</subject><subject>Heart</subject><subject>Heart failure</subject><subject>Heart surgery</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Infections</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Population</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Recurrence</subject><subject>Studies</subject><subject>Survival Rate</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kl2L1DAUhoMo7rj6A7yRgix40-7JR5MWQZBl_cCFvVCvQ3qSaGqnHZN22Pn3pszowl54lbzheU_OeTmEvKRQUaDysq_Mz75iQFkFogLgj8iGQqtKqYR4TDYAwMpGAT8jz1Lqs5SskU_JGWOqrVnTbMiX6zt0KRXbKc5mCPOhMKNdVRfsqsJY7Mwc3DinIi1xH_Zh_JFfvcM57F3hRjuhiZkN6Tl54s2Q3IvTeU6-f7j-dvWpvLn9-Pnq_U2JNWdz6SXStpW1MQqh9TU4LzrprGecduhRYtaoahRWWU6tsai47FSr8jii8fycvDnW3cXp9-LSrLchoRsGM7ppSZoCk7KRDYiMvn6A9tMSx9ydpjUIyRvBIVP0SGGcUorO610MWxMPuZRek9a9zknrNWkNQueks-fVqfLSbZ395_gbbQYuToBJaAYfzYgh3XOSNjWwOnNvj5zLke2DizphzhudDTGHrO0U_tvGuwduHMIY8oe_3MGl-2l1yh79dV2JdSMoWy9S8D_pjbBp</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Thuny, Franck, MD, PhD</creator><creator>Giorgi, Roch, MD, PhD</creator><creator>Habachi, Raja, MD</creator><creator>Ansaldi, Sebastien, MD</creator><creator>Le Dolley, Yvan, MD</creator><creator>Casalta, Jean-Paul, MD</creator><creator>Avierinos, Jean-François, MD</creator><creator>Riberi, Alberto, MD</creator><creator>Renard, Sebastien, MD</creator><creator>Collart, Frederic, MD</creator><creator>Raoult, Didier, MD, PhD</creator><creator>Habib, Gilbert, MD</creator><general>Mosby, Inc</general><general>Mosby</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120701</creationdate><title>Excess mortality and morbidity in patients surviving infective endocarditis</title><author>Thuny, Franck, MD, PhD ; Giorgi, Roch, MD, PhD ; Habachi, Raja, MD ; Ansaldi, Sebastien, MD ; Le Dolley, Yvan, MD ; Casalta, Jean-Paul, MD ; Avierinos, Jean-François, MD ; Riberi, Alberto, MD ; Renard, Sebastien, MD ; Collart, Frederic, MD ; Raoult, Didier, MD, PhD ; Habib, Gilbert, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c532t-f6c19965aa7c09f50ef4b6edf231bcfc6cf4bc75c4d7d31dadc736b79700248f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Age</topic><topic>Biological and medical sciences</topic><topic>Calendars</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Drug therapy</topic><topic>Endocardial and cardiac valvular diseases</topic><topic>Endocarditis, Bacterial - complications</topic><topic>Endocarditis, Bacterial - mortality</topic><topic>Endocarditis, Bacterial - surgery</topic><topic>Female</topic><topic>Generalized linear models</topic><topic>Heart</topic><topic>Heart failure</topic><topic>Heart surgery</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Infections</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Population</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Studies</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thuny, Franck, MD, PhD</creatorcontrib><creatorcontrib>Giorgi, Roch, MD, PhD</creatorcontrib><creatorcontrib>Habachi, Raja, MD</creatorcontrib><creatorcontrib>Ansaldi, Sebastien, MD</creatorcontrib><creatorcontrib>Le Dolley, Yvan, MD</creatorcontrib><creatorcontrib>Casalta, Jean-Paul, MD</creatorcontrib><creatorcontrib>Avierinos, Jean-François, MD</creatorcontrib><creatorcontrib>Riberi, Alberto, MD</creatorcontrib><creatorcontrib>Renard, Sebastien, MD</creatorcontrib><creatorcontrib>Collart, Frederic, MD</creatorcontrib><creatorcontrib>Raoult, Didier, MD, PhD</creatorcontrib><creatorcontrib>Habib, Gilbert, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thuny, Franck, MD, PhD</au><au>Giorgi, Roch, MD, PhD</au><au>Habachi, Raja, MD</au><au>Ansaldi, Sebastien, MD</au><au>Le Dolley, Yvan, MD</au><au>Casalta, Jean-Paul, MD</au><au>Avierinos, Jean-François, MD</au><au>Riberi, Alberto, MD</au><au>Renard, Sebastien, MD</au><au>Collart, Frederic, MD</au><au>Raoult, Didier, MD, PhD</au><au>Habib, Gilbert, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Excess mortality and morbidity in patients surviving infective endocarditis</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>164</volume><issue>1</issue><spage>94</spage><epage>101</epage><pages>94-101</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background Mortality and morbidity associated with infective endocarditis may extend beyond successful treatment. The primary objective was to analyze rates, temporal changes, and predictors of excess mortality in patients surviving the acute phase of endocarditis. The secondary objective was to determine the rate of recurrence and the need for late cardiac surgery. Methods An observational cohort study was conducted at a university-affiliated tertiary medical center, among 328 patients who survived the active phase of endocarditis. We used age-, sex-, and calendar year–specific mortality hazard rates of the Bouches-du-Rhone French district population to calculate expected survival and excess mortality. The risk of recurrence and late valve surgery was also assessed. Result Compared with expected survival, patients surviving a first episode of endocarditis had significantly worse outcomes ( P = .001). The relative survival rates at 1, 3, and 5 years were 92% (95% CI, 88%-95%), 86% (95% CI, 77%-92%), and 82% (95% CI, 59%-91%), respectively. This excess mortality was observed during the entire follow-up period but was the highest during the first year after hospital discharge. Most of the recurrences and late cardiac surgeries also occurred during this period. Women exhibited a higher risk of age-adjusted excess mortality (adjusted excess hazard ratio, 2.0; 95% CI, 1.05-3.82; P = .03). Comorbidity index, recurrence of endocarditis, and history of an aortic valve endocarditis in women were independent predictors of excess mortality. Conclusions These results justify close monitoring of patients after successful treatment of endocarditis, at least during the first year. Special attention should be paid to women with aortic valve damage.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>22795288</pmid><doi>10.1016/j.ahj.2012.04.003</doi><tpages>8</tpages></addata></record> |
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| subjects | Age Biological and medical sciences Calendars Cardiology. Vascular system Cardiovascular Cohort Studies Comorbidity Drug therapy Endocardial and cardiac valvular diseases Endocarditis, Bacterial - complications Endocarditis, Bacterial - mortality Endocarditis, Bacterial - surgery Female Generalized linear models Heart Heart failure Heart surgery Hospitalization Humans Infections Male Medical prognosis Medical sciences Middle Aged Mortality Population Prognosis Prospective Studies Recurrence Studies Survival Rate |
| title | Excess mortality and morbidity in patients surviving infective endocarditis |
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