Value of surgery for infective endocarditis in dialysis patients
Abstract Objectives To determine the value of surgery for infective endocarditis (IE) in patients on hemodialysis by comparing the nature and invasiveness of endocarditis in hemodialysis and nonhemodialysis patients and their hospital and long-term outcomes, and identifying risk factors for time-rel...
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| creator | Raza, Sajjad, MD Hussain, Syed T., MD Rajeswaran, Jeevanantham, PhD Ansari, Asif, MD Trezzi, Matteo, MD Arafat, Amr, MD Witten, James, BS Ravichandren, Kirthi, MD Riaz, Haris, MD Javadikasgari, Hoda, MD Panwar, Sunil, MD Demirjian, Sevag, MD Shrestha, Nabin K., MD Fraser, Thomas G., MD Navia, José L., MD Lytle, Bruce W., MD Blackstone, Eugene H., MD Pettersson, Gösta B., MD, PhD |
| description | Abstract Objectives To determine the value of surgery for infective endocarditis (IE) in patients on hemodialysis by comparing the nature and invasiveness of endocarditis in hemodialysis and nonhemodialysis patients and their hospital and long-term outcomes, and identifying risk factors for time-related mortality after surgery. Methods From January 1997 to January 2013, 144 patients on chronic hemodialysis and 1233 nonhemodialysis patients underwent valve surgery for IE at our institution. Propensity matching identified 99 well-matched hemodialysis and nonhemodialysis patient pairs for comparison of outcomes. Results Staphylococcus aureus infection was more common in hemodialysis patients than in nonhemodialysis patients (42% vs 21%; P |
| doi_str_mv | 10.1016/j.jtcvs.2017.02.063 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1912194904</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0022522317305536</els_id><sourcerecordid>1912194904</sourcerecordid><originalsourceid>FETCH-LOGICAL-c459t-3c38232c045e1abb1a76e313462af04924fa3e12a70cd0acb691b3b20f5a6f9e3</originalsourceid><addsrcrecordid>eNqFkUFP3DAQha0KVBbaX1AJ5cgl6YydOOtDEQi1FAmJAy3iZjnOuHLIJoudrLT_vt4u5cCF04xG781ovsfYF4QCAeXXrugmu4kFB6wL4AVI8YEtEFSdy2X1eMAWAJznFefiiB3H2AFADag-siO-lEJwhAW7eDD9TNnosjiHPxS2mRtD5gdHdvIbymhoR2tC6ycf0zhrvem3MfVrM3kapviJHTrTR_r8Uk_Y7x_ff139zG_vrm-uLm9zW1ZqyoUVSy64hbIiNE2DppYkUJSSGwel4qUzgpCbGmwLxjZSYSMaDq4y0ikSJ-xsv3cdxueZ4qRXPlrqezPQOEeNCjmqUkGZpGIvtWGMMZDT6-BXJmw1gt6h053-h07v0GngOqFLrtOXA3OzovbV859VEnzbCyi9ufEUdLQJgaXWh0RLt6N_58D5G7_t_eCt6Z9oS7Eb5zAkghp1TAZ9v0tvFx7WAqpKSPEXEiqVXA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1912194904</pqid></control><display><type>article</type><title>Value of surgery for infective endocarditis in dialysis patients</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Raza, Sajjad, MD ; Hussain, Syed T., MD ; Rajeswaran, Jeevanantham, PhD ; Ansari, Asif, MD ; Trezzi, Matteo, MD ; Arafat, Amr, MD ; Witten, James, BS ; Ravichandren, Kirthi, MD ; Riaz, Haris, MD ; Javadikasgari, Hoda, MD ; Panwar, Sunil, MD ; Demirjian, Sevag, MD ; Shrestha, Nabin K., MD ; Fraser, Thomas G., MD ; Navia, José L., MD ; Lytle, Bruce W., MD ; Blackstone, Eugene H., MD ; Pettersson, Gösta B., MD, PhD</creator><creatorcontrib>Raza, Sajjad, MD ; Hussain, Syed T., MD ; Rajeswaran, Jeevanantham, PhD ; Ansari, Asif, MD ; Trezzi, Matteo, MD ; Arafat, Amr, MD ; Witten, James, BS ; Ravichandren, Kirthi, MD ; Riaz, Haris, MD ; Javadikasgari, Hoda, MD ; Panwar, Sunil, MD ; Demirjian, Sevag, MD ; Shrestha, Nabin K., MD ; Fraser, Thomas G., MD ; Navia, José L., MD ; Lytle, Bruce W., MD ; Blackstone, Eugene H., MD ; Pettersson, Gösta B., MD, PhD</creatorcontrib><description>Abstract Objectives To determine the value of surgery for infective endocarditis (IE) in patients on hemodialysis by comparing the nature and invasiveness of endocarditis in hemodialysis and nonhemodialysis patients and their hospital and long-term outcomes, and identifying risk factors for time-related mortality after surgery. Methods From January 1997 to January 2013, 144 patients on chronic hemodialysis and 1233 nonhemodialysis patients underwent valve surgery for IE at our institution. Propensity matching identified 99 well-matched hemodialysis and nonhemodialysis patient pairs for comparison of outcomes. Results Staphylococcus aureus infection was more common in hemodialysis patients than in nonhemodialysis patients (42% vs 21%; P < .0001), but invasive disease was similar in the 2 groups (47%; P = .3). Hospital mortality was 13% and 5-year survival was 20% for hemodialysis patients, 20% below that expected in a general hemodialysis population but 15% above that of hemodialysis patients treated nonsurgically for IE. For matched patients, hospital mortality was 13% for hemodialysis patients versus 5.1% for nonhemodialysis patients ( P = .05), and survival at 1 and 5 years was 56% versus 83% and 24% versus 59%, respectively ( P < .004). Use of an arteriovenous graft for dialysis access ( P = .01) and preoperative placement of a pacemaker ( P < .0001) were risk factors for late mortality in hemodialysis patients. For matched patients, freedom from reoperation was similar in the hemodialysis and nonhemodialysis groups ( P > .9). Conclusions Intermediate-term survival after surgery for IE in hemodialysis patients is substantially worse than that in nonhemodialysis patients, but only slightly worse than that in the general hemodialysis population and substantially better than that in hemodialysis patients with IE treated nonsurgically, supporting continued surgical intervention for IE.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2017.02.063</identifier><identifier>PMID: 28633210</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Cardiac Surgical Procedures - mortality ; Cardiothoracic Surgery ; Case-Control Studies ; Echocardiography ; Endocarditis - diagnostic imaging ; Endocarditis - etiology ; Endocarditis - mortality ; Endocarditis - surgery ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Propensity Score ; Renal Dialysis - adverse effects ; reoperation ; Risk Factors ; survival ; Survival Analysis ; Treatment Outcome ; valve surgery</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2017-07, Vol.154 (1), p.61-70.e6</ispartof><rights>2017</rights><rights>Copyright © 2017. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-3c38232c045e1abb1a76e313462af04924fa3e12a70cd0acb691b3b20f5a6f9e3</citedby><cites>FETCH-LOGICAL-c459t-3c38232c045e1abb1a76e313462af04924fa3e12a70cd0acb691b3b20f5a6f9e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022522317305536$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28633210$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Raza, Sajjad, MD</creatorcontrib><creatorcontrib>Hussain, Syed T., MD</creatorcontrib><creatorcontrib>Rajeswaran, Jeevanantham, PhD</creatorcontrib><creatorcontrib>Ansari, Asif, MD</creatorcontrib><creatorcontrib>Trezzi, Matteo, MD</creatorcontrib><creatorcontrib>Arafat, Amr, MD</creatorcontrib><creatorcontrib>Witten, James, BS</creatorcontrib><creatorcontrib>Ravichandren, Kirthi, MD</creatorcontrib><creatorcontrib>Riaz, Haris, MD</creatorcontrib><creatorcontrib>Javadikasgari, Hoda, MD</creatorcontrib><creatorcontrib>Panwar, Sunil, MD</creatorcontrib><creatorcontrib>Demirjian, Sevag, MD</creatorcontrib><creatorcontrib>Shrestha, Nabin K., MD</creatorcontrib><creatorcontrib>Fraser, Thomas G., MD</creatorcontrib><creatorcontrib>Navia, José L., MD</creatorcontrib><creatorcontrib>Lytle, Bruce W., MD</creatorcontrib><creatorcontrib>Blackstone, Eugene H., MD</creatorcontrib><creatorcontrib>Pettersson, Gösta B., MD, PhD</creatorcontrib><title>Value of surgery for infective endocarditis in dialysis patients</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Abstract Objectives To determine the value of surgery for infective endocarditis (IE) in patients on hemodialysis by comparing the nature and invasiveness of endocarditis in hemodialysis and nonhemodialysis patients and their hospital and long-term outcomes, and identifying risk factors for time-related mortality after surgery. Methods From January 1997 to January 2013, 144 patients on chronic hemodialysis and 1233 nonhemodialysis patients underwent valve surgery for IE at our institution. Propensity matching identified 99 well-matched hemodialysis and nonhemodialysis patient pairs for comparison of outcomes. Results Staphylococcus aureus infection was more common in hemodialysis patients than in nonhemodialysis patients (42% vs 21%; P < .0001), but invasive disease was similar in the 2 groups (47%; P = .3). Hospital mortality was 13% and 5-year survival was 20% for hemodialysis patients, 20% below that expected in a general hemodialysis population but 15% above that of hemodialysis patients treated nonsurgically for IE. For matched patients, hospital mortality was 13% for hemodialysis patients versus 5.1% for nonhemodialysis patients ( P = .05), and survival at 1 and 5 years was 56% versus 83% and 24% versus 59%, respectively ( P < .004). Use of an arteriovenous graft for dialysis access ( P = .01) and preoperative placement of a pacemaker ( P < .0001) were risk factors for late mortality in hemodialysis patients. For matched patients, freedom from reoperation was similar in the hemodialysis and nonhemodialysis groups ( P > .9). Conclusions Intermediate-term survival after surgery for IE in hemodialysis patients is substantially worse than that in nonhemodialysis patients, but only slightly worse than that in the general hemodialysis population and substantially better than that in hemodialysis patients with IE treated nonsurgically, supporting continued surgical intervention for IE.</description><subject>Adult</subject><subject>Aged</subject><subject>Cardiac Surgical Procedures - mortality</subject><subject>Cardiothoracic Surgery</subject><subject>Case-Control Studies</subject><subject>Echocardiography</subject><subject>Endocarditis - diagnostic imaging</subject><subject>Endocarditis - etiology</subject><subject>Endocarditis - mortality</subject><subject>Endocarditis - surgery</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Propensity Score</subject><subject>Renal Dialysis - adverse effects</subject><subject>reoperation</subject><subject>Risk Factors</subject><subject>survival</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>valve surgery</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUFP3DAQha0KVBbaX1AJ5cgl6YydOOtDEQi1FAmJAy3iZjnOuHLIJoudrLT_vt4u5cCF04xG781ovsfYF4QCAeXXrugmu4kFB6wL4AVI8YEtEFSdy2X1eMAWAJznFefiiB3H2AFADag-siO-lEJwhAW7eDD9TNnosjiHPxS2mRtD5gdHdvIbymhoR2tC6ycf0zhrvem3MfVrM3kapviJHTrTR_r8Uk_Y7x_ff139zG_vrm-uLm9zW1ZqyoUVSy64hbIiNE2DppYkUJSSGwel4qUzgpCbGmwLxjZSYSMaDq4y0ikSJ-xsv3cdxueZ4qRXPlrqezPQOEeNCjmqUkGZpGIvtWGMMZDT6-BXJmw1gt6h053-h07v0GngOqFLrtOXA3OzovbV859VEnzbCyi9ufEUdLQJgaXWh0RLt6N_58D5G7_t_eCt6Z9oS7Eb5zAkghp1TAZ9v0tvFx7WAqpKSPEXEiqVXA</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Raza, Sajjad, MD</creator><creator>Hussain, Syed T., MD</creator><creator>Rajeswaran, Jeevanantham, PhD</creator><creator>Ansari, Asif, MD</creator><creator>Trezzi, Matteo, MD</creator><creator>Arafat, Amr, MD</creator><creator>Witten, James, BS</creator><creator>Ravichandren, Kirthi, MD</creator><creator>Riaz, Haris, MD</creator><creator>Javadikasgari, Hoda, MD</creator><creator>Panwar, Sunil, MD</creator><creator>Demirjian, Sevag, MD</creator><creator>Shrestha, Nabin K., MD</creator><creator>Fraser, Thomas G., MD</creator><creator>Navia, José L., MD</creator><creator>Lytle, Bruce W., MD</creator><creator>Blackstone, Eugene H., MD</creator><creator>Pettersson, Gösta B., MD, PhD</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</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>7X8</scope></search><sort><creationdate>20170701</creationdate><title>Value of surgery for infective endocarditis in dialysis patients</title><author>Raza, Sajjad, MD ; Hussain, Syed T., MD ; Rajeswaran, Jeevanantham, PhD ; Ansari, Asif, MD ; Trezzi, Matteo, MD ; Arafat, Amr, MD ; Witten, James, BS ; Ravichandren, Kirthi, MD ; Riaz, Haris, MD ; Javadikasgari, Hoda, MD ; Panwar, Sunil, MD ; Demirjian, Sevag, MD ; Shrestha, Nabin K., MD ; Fraser, Thomas G., MD ; Navia, José L., MD ; Lytle, Bruce W., MD ; Blackstone, Eugene H., MD ; Pettersson, Gösta B., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-3c38232c045e1abb1a76e313462af04924fa3e12a70cd0acb691b3b20f5a6f9e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Cardiac Surgical Procedures - mortality</topic><topic>Cardiothoracic Surgery</topic><topic>Case-Control Studies</topic><topic>Echocardiography</topic><topic>Endocarditis - diagnostic imaging</topic><topic>Endocarditis - etiology</topic><topic>Endocarditis - mortality</topic><topic>Endocarditis - surgery</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Propensity Score</topic><topic>Renal Dialysis - adverse effects</topic><topic>reoperation</topic><topic>Risk Factors</topic><topic>survival</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><topic>valve surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Raza, Sajjad, MD</creatorcontrib><creatorcontrib>Hussain, Syed T., MD</creatorcontrib><creatorcontrib>Rajeswaran, Jeevanantham, PhD</creatorcontrib><creatorcontrib>Ansari, Asif, MD</creatorcontrib><creatorcontrib>Trezzi, Matteo, MD</creatorcontrib><creatorcontrib>Arafat, Amr, MD</creatorcontrib><creatorcontrib>Witten, James, BS</creatorcontrib><creatorcontrib>Ravichandren, Kirthi, MD</creatorcontrib><creatorcontrib>Riaz, Haris, MD</creatorcontrib><creatorcontrib>Javadikasgari, Hoda, MD</creatorcontrib><creatorcontrib>Panwar, Sunil, MD</creatorcontrib><creatorcontrib>Demirjian, Sevag, MD</creatorcontrib><creatorcontrib>Shrestha, Nabin K., MD</creatorcontrib><creatorcontrib>Fraser, Thomas G., MD</creatorcontrib><creatorcontrib>Navia, José L., MD</creatorcontrib><creatorcontrib>Lytle, Bruce W., MD</creatorcontrib><creatorcontrib>Blackstone, Eugene H., MD</creatorcontrib><creatorcontrib>Pettersson, Gösta B., MD, PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><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>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Raza, Sajjad, MD</au><au>Hussain, Syed T., MD</au><au>Rajeswaran, Jeevanantham, PhD</au><au>Ansari, Asif, MD</au><au>Trezzi, Matteo, MD</au><au>Arafat, Amr, MD</au><au>Witten, James, BS</au><au>Ravichandren, Kirthi, MD</au><au>Riaz, Haris, MD</au><au>Javadikasgari, Hoda, MD</au><au>Panwar, Sunil, MD</au><au>Demirjian, Sevag, MD</au><au>Shrestha, Nabin K., MD</au><au>Fraser, Thomas G., MD</au><au>Navia, José L., MD</au><au>Lytle, Bruce W., MD</au><au>Blackstone, Eugene H., MD</au><au>Pettersson, Gösta B., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Value of surgery for infective endocarditis in dialysis patients</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>154</volume><issue>1</issue><spage>61</spage><epage>70.e6</epage><pages>61-70.e6</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><abstract>Abstract Objectives To determine the value of surgery for infective endocarditis (IE) in patients on hemodialysis by comparing the nature and invasiveness of endocarditis in hemodialysis and nonhemodialysis patients and their hospital and long-term outcomes, and identifying risk factors for time-related mortality after surgery. Methods From January 1997 to January 2013, 144 patients on chronic hemodialysis and 1233 nonhemodialysis patients underwent valve surgery for IE at our institution. Propensity matching identified 99 well-matched hemodialysis and nonhemodialysis patient pairs for comparison of outcomes. Results Staphylococcus aureus infection was more common in hemodialysis patients than in nonhemodialysis patients (42% vs 21%; P < .0001), but invasive disease was similar in the 2 groups (47%; P = .3). Hospital mortality was 13% and 5-year survival was 20% for hemodialysis patients, 20% below that expected in a general hemodialysis population but 15% above that of hemodialysis patients treated nonsurgically for IE. For matched patients, hospital mortality was 13% for hemodialysis patients versus 5.1% for nonhemodialysis patients ( P = .05), and survival at 1 and 5 years was 56% versus 83% and 24% versus 59%, respectively ( P < .004). Use of an arteriovenous graft for dialysis access ( P = .01) and preoperative placement of a pacemaker ( P < .0001) were risk factors for late mortality in hemodialysis patients. For matched patients, freedom from reoperation was similar in the hemodialysis and nonhemodialysis groups ( P > .9). Conclusions Intermediate-term survival after surgery for IE in hemodialysis patients is substantially worse than that in nonhemodialysis patients, but only slightly worse than that in the general hemodialysis population and substantially better than that in hemodialysis patients with IE treated nonsurgically, supporting continued surgical intervention for IE.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28633210</pmid><doi>10.1016/j.jtcvs.2017.02.063</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Cardiac Surgical Procedures - mortality Cardiothoracic Surgery Case-Control Studies Echocardiography Endocarditis - diagnostic imaging Endocarditis - etiology Endocarditis - mortality Endocarditis - surgery Female Hospital Mortality Humans Male Middle Aged Propensity Score Renal Dialysis - adverse effects reoperation Risk Factors survival Survival Analysis Treatment Outcome valve surgery |
| title | Value of surgery for infective endocarditis in dialysis patients |
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