Preoperative Increasing C-reactive Protein Affects the Outcome for Active Infective Endocarditis
Purpose: This study aimed to determine if preoperative time course changes in serum C-reactive protein (CRP) levels can predict clinical outcome of surgical intervention for active infective endocarditis. Methods: Surgically treated patients (n = 109) with active infective endocarditis were reviewed...
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| Veröffentlicht in: | Annals of Thoracic and Cardiovascular Surgery 2014, Vol.20(1), pp.48-54 |
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| creator | Okada, Yuko Hosono, Mitsuharu Sasaki, Yasuyuki Hirai, Hidekazu Suehiro, Shigefumi |
| description | Purpose: This study aimed to determine if preoperative time course changes in serum C-reactive protein (CRP) levels can predict clinical outcome of surgical intervention for active infective endocarditis. Methods: Surgically treated patients (n = 109) with active infective endocarditis were reviewed retrospectively. We divided the patients into 2 subgroups according to preoperative transition of increasing or decreasing serum CRP levels, and performed a comparative study. The increasing CRP group included 29 patients and the decreasing CRP group included 80 patients. Results: There were more patients with methicillin-resistant Staphylococcus aureus and New York Heart Association functional class IV in the increasing CRP group. Hospital mortality was signifi cantly higher in the increasing CRP group (34.5%) than that in the decreasing CRP group (5.0%) (p |
| doi_str_mv | 10.5761/atcs.oa.12.02091 |
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Methods: Surgically treated patients (n = 109) with active infective endocarditis were reviewed retrospectively. We divided the patients into 2 subgroups according to preoperative transition of increasing or decreasing serum CRP levels, and performed a comparative study. The increasing CRP group included 29 patients and the decreasing CRP group included 80 patients. Results: There were more patients with methicillin-resistant Staphylococcus aureus and New York Heart Association functional class IV in the increasing CRP group. Hospital mortality was signifi cantly higher in the increasing CRP group (34.5%) than that in the decreasing CRP group (5.0%) (p <0.05). In multivariate analysis, 3 signifi cant risk factors of surgical outcome were identifi ed: a tendency for increasing preoperative CRP levels (odds ratio [OR]: 18.15, 95% confi dence interval [CI]: 1.03-320.78), nosocomial infective endocarditis (OR: 18.73, 95% CI: 1.57-223.60), and dialysis (OR: 1025.46, 95% CI: 2.89-363587.12). Conclusion: The outcome of operations for patients with increasing preoperative CRP levels is poor. For treatment of active infective endocarditis, a better operative result is expected when preoperative CRP levels are decreasing.</description><identifier>ISSN: 1341-1098</identifier><identifier>EISSN: 2186-1005</identifier><identifier>DOI: 10.5761/atcs.oa.12.02091</identifier><identifier>PMID: 23411851</identifier><language>eng</language><publisher>Japan: The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery</publisher><subject>Adult ; Aged ; Anti-Bacterial Agents - therapeutic use ; Biomarkers - blood ; c-reactive protein ; C-Reactive Protein - metabolism ; Cardiac Surgical Procedures - adverse effects ; Cardiac Surgical Procedures - mortality ; Cross Infection - blood ; Cross Infection - diagnosis ; Cross Infection - microbiology ; Cross Infection - surgery ; Endocarditis, Bacterial - blood ; Endocarditis, Bacterial - diagnosis ; Endocarditis, Bacterial - microbiology ; Endocarditis, Bacterial - mortality ; Endocarditis, Bacterial - surgery ; Female ; Hospital Mortality ; Humans ; infective endocarditis ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome ; Up-Regulation ; valve replacement</subject><ispartof>Annals of Thoracic and Cardiovascular Surgery, 2014, Vol.20(1), pp.48-54</ispartof><rights>2014 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c595t-822678632c80f8588fa2ad0dd388e49022fefcc4c04c76a66c3c98f5f18980b13</citedby><cites>FETCH-LOGICAL-c595t-822678632c80f8588fa2ad0dd388e49022fefcc4c04c76a66c3c98f5f18980b13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,865,1884,4025,27928,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23411851$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Okada, Yuko</creatorcontrib><creatorcontrib>Hosono, Mitsuharu</creatorcontrib><creatorcontrib>Sasaki, Yasuyuki</creatorcontrib><creatorcontrib>Hirai, Hidekazu</creatorcontrib><creatorcontrib>Suehiro, Shigefumi</creatorcontrib><title>Preoperative Increasing C-reactive Protein Affects the Outcome for Active Infective Endocarditis</title><title>Annals of Thoracic and Cardiovascular Surgery</title><addtitle>ATCS</addtitle><description>Purpose: This study aimed to determine if preoperative time course changes in serum C-reactive protein (CRP) levels can predict clinical outcome of surgical intervention for active infective endocarditis. Methods: Surgically treated patients (n = 109) with active infective endocarditis were reviewed retrospectively. We divided the patients into 2 subgroups according to preoperative transition of increasing or decreasing serum CRP levels, and performed a comparative study. The increasing CRP group included 29 patients and the decreasing CRP group included 80 patients. Results: There were more patients with methicillin-resistant Staphylococcus aureus and New York Heart Association functional class IV in the increasing CRP group. Hospital mortality was signifi cantly higher in the increasing CRP group (34.5%) than that in the decreasing CRP group (5.0%) (p <0.05). In multivariate analysis, 3 signifi cant risk factors of surgical outcome were identifi ed: a tendency for increasing preoperative CRP levels (odds ratio [OR]: 18.15, 95% confi dence interval [CI]: 1.03-320.78), nosocomial infective endocarditis (OR: 18.73, 95% CI: 1.57-223.60), and dialysis (OR: 1025.46, 95% CI: 2.89-363587.12). Conclusion: The outcome of operations for patients with increasing preoperative CRP levels is poor. For treatment of active infective endocarditis, a better operative result is expected when preoperative CRP levels are decreasing.</description><subject>Adult</subject><subject>Aged</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Biomarkers - blood</subject><subject>c-reactive protein</subject><subject>C-Reactive Protein - metabolism</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiac Surgical Procedures - mortality</subject><subject>Cross Infection - blood</subject><subject>Cross Infection - diagnosis</subject><subject>Cross Infection - microbiology</subject><subject>Cross Infection - surgery</subject><subject>Endocarditis, Bacterial - blood</subject><subject>Endocarditis, Bacterial - diagnosis</subject><subject>Endocarditis, Bacterial - microbiology</subject><subject>Endocarditis, Bacterial - mortality</subject><subject>Endocarditis, Bacterial - surgery</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>infective endocarditis</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Up-Regulation</subject><subject>valve replacement</subject><issn>1341-1098</issn><issn>2186-1005</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkEFPAjEQhRujUUTvnswevSxOu7R0j4SImpjAQc-1zE5hDWyxLSb-e3cFiZeZl873XtLH2A2HgRwpfm8TxoG3Ay4GIKDkJ6wnuFY5B5CnrMeLIW91qS_YZYwfAIVWCs7ZhWgPXEveY-_zQH5Lwab6i7LnBgPZWDfLbJK3Cn9f58Enqpts7BxhillaUTbbJfQbypwP2RgP5u7cqYem8mhDVac6XrEzZ9eRrg-7z96mD6-Tp_xl9vg8Gb_kKEuZci2EGmlVCNTgtNTaWWErqKpCaxqWIIQjhzhEGOJIWaWwwFI76bguNSx40Wd3-9xt8J87isls6oi0XtuG_C4aLttPg5Aj3aKwRzH4GAM5sw31xoZvw8F0vZquV-Ot4cL89tpabg_pu8WGqqPhr8gWmO6Bj5jsko6ADanGNe0TBRjejX_JRwBXNhhqih9B1Y5_</recordid><startdate>2014</startdate><enddate>2014</enddate><creator>Okada, Yuko</creator><creator>Hosono, Mitsuharu</creator><creator>Sasaki, Yasuyuki</creator><creator>Hirai, Hidekazu</creator><creator>Suehiro, Shigefumi</creator><general>The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery</general><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>7X8</scope></search><sort><creationdate>2014</creationdate><title>Preoperative Increasing C-reactive Protein Affects the Outcome for Active Infective Endocarditis</title><author>Okada, Yuko ; Hosono, Mitsuharu ; Sasaki, Yasuyuki ; Hirai, Hidekazu ; Suehiro, Shigefumi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c595t-822678632c80f8588fa2ad0dd388e49022fefcc4c04c76a66c3c98f5f18980b13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Biomarkers - blood</topic><topic>c-reactive protein</topic><topic>C-Reactive Protein - metabolism</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiac Surgical Procedures - mortality</topic><topic>Cross Infection - blood</topic><topic>Cross Infection - diagnosis</topic><topic>Cross Infection - microbiology</topic><topic>Cross Infection - surgery</topic><topic>Endocarditis, Bacterial - blood</topic><topic>Endocarditis, Bacterial - diagnosis</topic><topic>Endocarditis, Bacterial - microbiology</topic><topic>Endocarditis, Bacterial - mortality</topic><topic>Endocarditis, Bacterial - surgery</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>infective endocarditis</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Up-Regulation</topic><topic>valve replacement</topic><toplevel>online_resources</toplevel><creatorcontrib>Okada, Yuko</creatorcontrib><creatorcontrib>Hosono, Mitsuharu</creatorcontrib><creatorcontrib>Sasaki, Yasuyuki</creatorcontrib><creatorcontrib>Hirai, Hidekazu</creatorcontrib><creatorcontrib>Suehiro, Shigefumi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of Thoracic and Cardiovascular Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Okada, Yuko</au><au>Hosono, Mitsuharu</au><au>Sasaki, Yasuyuki</au><au>Hirai, Hidekazu</au><au>Suehiro, Shigefumi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative Increasing C-reactive Protein Affects the Outcome for Active Infective Endocarditis</atitle><jtitle>Annals of Thoracic and Cardiovascular Surgery</jtitle><addtitle>ATCS</addtitle><date>2014</date><risdate>2014</risdate><volume>20</volume><issue>1</issue><spage>48</spage><epage>54</epage><pages>48-54</pages><issn>1341-1098</issn><eissn>2186-1005</eissn><abstract>Purpose: This study aimed to determine if preoperative time course changes in serum C-reactive protein (CRP) levels can predict clinical outcome of surgical intervention for active infective endocarditis. Methods: Surgically treated patients (n = 109) with active infective endocarditis were reviewed retrospectively. We divided the patients into 2 subgroups according to preoperative transition of increasing or decreasing serum CRP levels, and performed a comparative study. The increasing CRP group included 29 patients and the decreasing CRP group included 80 patients. Results: There were more patients with methicillin-resistant Staphylococcus aureus and New York Heart Association functional class IV in the increasing CRP group. Hospital mortality was signifi cantly higher in the increasing CRP group (34.5%) than that in the decreasing CRP group (5.0%) (p <0.05). In multivariate analysis, 3 signifi cant risk factors of surgical outcome were identifi ed: a tendency for increasing preoperative CRP levels (odds ratio [OR]: 18.15, 95% confi dence interval [CI]: 1.03-320.78), nosocomial infective endocarditis (OR: 18.73, 95% CI: 1.57-223.60), and dialysis (OR: 1025.46, 95% CI: 2.89-363587.12). Conclusion: The outcome of operations for patients with increasing preoperative CRP levels is poor. For treatment of active infective endocarditis, a better operative result is expected when preoperative CRP levels are decreasing.</abstract><cop>Japan</cop><pub>The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery</pub><pmid>23411851</pmid><doi>10.5761/atcs.oa.12.02091</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Anti-Bacterial Agents - therapeutic use Biomarkers - blood c-reactive protein C-Reactive Protein - metabolism Cardiac Surgical Procedures - adverse effects Cardiac Surgical Procedures - mortality Cross Infection - blood Cross Infection - diagnosis Cross Infection - microbiology Cross Infection - surgery Endocarditis, Bacterial - blood Endocarditis, Bacterial - diagnosis Endocarditis, Bacterial - microbiology Endocarditis, Bacterial - mortality Endocarditis, Bacterial - surgery Female Hospital Mortality Humans infective endocarditis Logistic Models Male Middle Aged Multivariate Analysis Odds Ratio Retrospective Studies Risk Factors Time Factors Treatment Outcome Up-Regulation valve replacement |
| title | Preoperative Increasing C-reactive Protein Affects the Outcome for Active Infective Endocarditis |
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