Analysis of Short- and Long-term Outcomes of Patients With Surgically Treated Left-sided Infective Endocarditis: A 5-Year Longitudinal Follow-up Study
This study aims to analyze survival, repeat hospitalization, and risk factors for surgically treated left-sided endocarditis. Retrospective review of all 166 (114 native and 52 prosthetic) patients operated between January 2004 and March 2015 was performed. Long-term survival and repeat hospitalizat...
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| Veröffentlicht in: | Seminars in thoracic and cardiovascular surgery 2017, Vol.29 (3), p.311-320 |
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| creator | Marushchak, Oksana Cole, Holy Hiebert, Brett Lo, Evelyn Keynan, Yoav Tam, James Shaikh, Nasir Menkis, Alan H. Arora, Rakesh C. Shah, Pallav |
| description | This study aims to analyze survival, repeat hospitalization, and risk factors for surgically treated left-sided endocarditis. Retrospective review of all 166 (114 native and 52 prosthetic) patients operated between January 2004 and March 2015 was performed. Long-term survival and repeat hospitalization data for 134 of 166 patients were obtained via linked clinical databases with the Manitoba Centre for Health Policy. Kaplan-Meier estimates of survival and hospital readmission and Cox multivariable regression analysis of factors influencing outcomes were performed. Survival at 1 and 5 years was 91% and 80%, respectively, and major adverse prosthesis-related event repeat hospitalization rates were 12% and 21%, respectively. Repeat hospitalization because of endocarditis was 7% and 11% at 1 and 5 years, respectively. Survival and repeat hospitalization were similar for aortic and mitral valves. Survival after surgically treated endocarditis was similar to survival for age-, sex-, and valve-matched surgical valve replacements for noninfectious indications (P = 0.53). Viridans Streptococci was the most common organism in native valve endocarditis, and culture negative endocarditis was most common in prosthetic valves. Prosthetic valve endocarditis (P |
| doi_str_mv | 10.1053/j.semtcvs.2017.08.002 |
| format | Article |
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Retrospective review of all 166 (114 native and 52 prosthetic) patients operated between January 2004 and March 2015 was performed. Long-term survival and repeat hospitalization data for 134 of 166 patients were obtained via linked clinical databases with the Manitoba Centre for Health Policy. Kaplan-Meier estimates of survival and hospital readmission and Cox multivariable regression analysis of factors influencing outcomes were performed. Survival at 1 and 5 years was 91% and 80%, respectively, and major adverse prosthesis-related event repeat hospitalization rates were 12% and 21%, respectively. Repeat hospitalization because of endocarditis was 7% and 11% at 1 and 5 years, respectively. Survival and repeat hospitalization were similar for aortic and mitral valves. Survival after surgically treated endocarditis was similar to survival for age-, sex-, and valve-matched surgical valve replacements for noninfectious indications (P = 0.53). Viridans Streptococci was the most common organism in native valve endocarditis, and culture negative endocarditis was most common in prosthetic valves. Prosthetic valve endocarditis (P < 0.01) and preoperative renal dysfunction (P < 0.01) were risk factors for in-hospital mortality and major postoperative adverse events. Diabetes and renal dysfunction were associated with poor long-term survival, functional survival, and repeat hospitalization. This analysis suggests that surgery remains a very effective tool in management of these complex patients in terms of survival and major adverse prosthesis-related event repeat hospitalization.</description><identifier>ISSN: 1043-0679</identifier><identifier>EISSN: 1532-9488</identifier><identifier>DOI: 10.1053/j.semtcvs.2017.08.002</identifier><identifier>PMID: 28935512</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Databases, Factual ; Endocarditis, Bacterial - diagnosis ; Endocarditis, Bacterial - microbiology ; Endocarditis, Bacterial - mortality ; Endocarditis, Bacterial - surgery ; Female ; Follow-Up Studies ; Heart Valve Prosthesis - adverse effects ; Heart Valve Prosthesis Implantation - adverse effects ; Heart Valve Prosthesis Implantation - instrumentation ; Heart Valve Prosthesis Implantation - mortality ; Hospital Mortality ; Humans ; infective endocarditis ; Kaplan-Meier Estimate ; left sided ; Logistic Models ; Longitudinal Studies ; Male ; Manitoba ; Middle Aged ; Multivariate Analysis ; outcomes ; Patient Readmission ; Postoperative Complications - mortality ; Postoperative Complications - therapy ; Proportional Hazards Models ; Prosthesis-Related Infections - diagnosis ; Prosthesis-Related Infections - microbiology ; Prosthesis-Related Infections - mortality ; Prosthesis-Related Infections - surgery ; Retrospective Studies ; Risk Factors ; surgical ; Time Factors ; Treatment Outcome</subject><ispartof>Seminars in thoracic and cardiovascular surgery, 2017, Vol.29 (3), p.311-320</ispartof><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-9a06ed66449df3ccd22048914b972aedf573d40476ff2912fa66fc3ce955367b3</citedby><cites>FETCH-LOGICAL-c365t-9a06ed66449df3ccd22048914b972aedf573d40476ff2912fa66fc3ce955367b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.semtcvs.2017.08.002$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28935512$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marushchak, Oksana</creatorcontrib><creatorcontrib>Cole, Holy</creatorcontrib><creatorcontrib>Hiebert, Brett</creatorcontrib><creatorcontrib>Lo, Evelyn</creatorcontrib><creatorcontrib>Keynan, Yoav</creatorcontrib><creatorcontrib>Tam, James</creatorcontrib><creatorcontrib>Shaikh, Nasir</creatorcontrib><creatorcontrib>Menkis, Alan H.</creatorcontrib><creatorcontrib>Arora, Rakesh C.</creatorcontrib><creatorcontrib>Shah, Pallav</creatorcontrib><title>Analysis of Short- and Long-term Outcomes of Patients With Surgically Treated Left-sided Infective Endocarditis: A 5-Year Longitudinal Follow-up Study</title><title>Seminars in thoracic and cardiovascular surgery</title><addtitle>Semin Thorac Cardiovasc Surg</addtitle><description>This study aims to analyze survival, repeat hospitalization, and risk factors for surgically treated left-sided endocarditis. Retrospective review of all 166 (114 native and 52 prosthetic) patients operated between January 2004 and March 2015 was performed. Long-term survival and repeat hospitalization data for 134 of 166 patients were obtained via linked clinical databases with the Manitoba Centre for Health Policy. Kaplan-Meier estimates of survival and hospital readmission and Cox multivariable regression analysis of factors influencing outcomes were performed. Survival at 1 and 5 years was 91% and 80%, respectively, and major adverse prosthesis-related event repeat hospitalization rates were 12% and 21%, respectively. Repeat hospitalization because of endocarditis was 7% and 11% at 1 and 5 years, respectively. Survival and repeat hospitalization were similar for aortic and mitral valves. Survival after surgically treated endocarditis was similar to survival for age-, sex-, and valve-matched surgical valve replacements for noninfectious indications (P = 0.53). Viridans Streptococci was the most common organism in native valve endocarditis, and culture negative endocarditis was most common in prosthetic valves. Prosthetic valve endocarditis (P < 0.01) and preoperative renal dysfunction (P < 0.01) were risk factors for in-hospital mortality and major postoperative adverse events. Diabetes and renal dysfunction were associated with poor long-term survival, functional survival, and repeat hospitalization. This analysis suggests that surgery remains a very effective tool in management of these complex patients in terms of survival and major adverse prosthesis-related event repeat hospitalization.</description><subject>Adult</subject><subject>Aged</subject><subject>Databases, Factual</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>Follow-Up Studies</subject><subject>Heart Valve Prosthesis - adverse effects</subject><subject>Heart Valve Prosthesis Implantation - adverse effects</subject><subject>Heart Valve Prosthesis Implantation - instrumentation</subject><subject>Heart Valve Prosthesis Implantation - mortality</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>infective endocarditis</subject><subject>Kaplan-Meier Estimate</subject><subject>left sided</subject><subject>Logistic Models</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Manitoba</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>outcomes</subject><subject>Patient Readmission</subject><subject>Postoperative Complications - mortality</subject><subject>Postoperative Complications - therapy</subject><subject>Proportional Hazards Models</subject><subject>Prosthesis-Related Infections - diagnosis</subject><subject>Prosthesis-Related Infections - microbiology</subject><subject>Prosthesis-Related Infections - mortality</subject><subject>Prosthesis-Related Infections - surgery</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>surgical</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1043-0679</issn><issn>1532-9488</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1uEzEUhUcIREvhEUBesnHw78yYDYqqFipFKlKKECvLsa9bRzPjYHuC8iI8L24T2LLylfUdn-tzmuYtJQtKJP-wXWQYi93nBSO0W5B-QQh71pxTyRlWou-f15kIjknbqbPmVc7bCtCO85fNGesVl5Ky8-b3cjLDIYeMokfrh5gKRmZyaBWne1wgjeh2LjaO8AR8NSXAVDL6HsoDWs_pPlgzDAd0l8AUqDLwBefg6ngzebAl7AFdTS5ak1woIX9ESyTxDzDpySKU2YW6AbqOwxB_4XmH1vXq8Lp54c2Q4c3pvGi-XV_dXX7Bq9vPN5fLFba8lQUrQ1pwbSuEcp5b6xgjoldUbFTHDDgvO-4EEV3rPVOUedO23nILSkredht-0bw_vrtL8ecMuegxZAvDYCaIc9ZUCdZ2grC-ovKI2hRzTuD1LoXRpIOmRD9Worf6VIl-rESTXtfEq-7dyWLejOD-qf52UIFPRwDqR_cBks62pmzBhVQT1C6G_1j8ATfAoWQ</recordid><startdate>2017</startdate><enddate>2017</enddate><creator>Marushchak, Oksana</creator><creator>Cole, Holy</creator><creator>Hiebert, Brett</creator><creator>Lo, Evelyn</creator><creator>Keynan, Yoav</creator><creator>Tam, James</creator><creator>Shaikh, Nasir</creator><creator>Menkis, Alan H.</creator><creator>Arora, Rakesh C.</creator><creator>Shah, Pallav</creator><general>Elsevier Inc</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>2017</creationdate><title>Analysis of Short- and Long-term Outcomes of Patients With Surgically Treated Left-sided Infective Endocarditis: A 5-Year Longitudinal Follow-up Study</title><author>Marushchak, Oksana ; Cole, Holy ; Hiebert, Brett ; Lo, Evelyn ; Keynan, Yoav ; Tam, James ; Shaikh, Nasir ; Menkis, Alan H. ; Arora, Rakesh C. ; Shah, Pallav</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-9a06ed66449df3ccd22048914b972aedf573d40476ff2912fa66fc3ce955367b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Databases, Factual</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>Follow-Up Studies</topic><topic>Heart Valve Prosthesis - adverse effects</topic><topic>Heart Valve Prosthesis Implantation - adverse effects</topic><topic>Heart Valve Prosthesis Implantation - instrumentation</topic><topic>Heart Valve Prosthesis Implantation - mortality</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>infective endocarditis</topic><topic>Kaplan-Meier Estimate</topic><topic>left sided</topic><topic>Logistic Models</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Manitoba</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>outcomes</topic><topic>Patient Readmission</topic><topic>Postoperative Complications - mortality</topic><topic>Postoperative Complications - therapy</topic><topic>Proportional Hazards Models</topic><topic>Prosthesis-Related Infections - diagnosis</topic><topic>Prosthesis-Related Infections - microbiology</topic><topic>Prosthesis-Related Infections - mortality</topic><topic>Prosthesis-Related Infections - surgery</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>surgical</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marushchak, Oksana</creatorcontrib><creatorcontrib>Cole, Holy</creatorcontrib><creatorcontrib>Hiebert, Brett</creatorcontrib><creatorcontrib>Lo, Evelyn</creatorcontrib><creatorcontrib>Keynan, Yoav</creatorcontrib><creatorcontrib>Tam, James</creatorcontrib><creatorcontrib>Shaikh, Nasir</creatorcontrib><creatorcontrib>Menkis, Alan H.</creatorcontrib><creatorcontrib>Arora, Rakesh C.</creatorcontrib><creatorcontrib>Shah, Pallav</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>Seminars in thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marushchak, Oksana</au><au>Cole, Holy</au><au>Hiebert, Brett</au><au>Lo, Evelyn</au><au>Keynan, Yoav</au><au>Tam, James</au><au>Shaikh, Nasir</au><au>Menkis, Alan H.</au><au>Arora, Rakesh C.</au><au>Shah, Pallav</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analysis of Short- and Long-term Outcomes of Patients With Surgically Treated Left-sided Infective Endocarditis: A 5-Year Longitudinal Follow-up Study</atitle><jtitle>Seminars in thoracic and cardiovascular surgery</jtitle><addtitle>Semin Thorac Cardiovasc Surg</addtitle><date>2017</date><risdate>2017</risdate><volume>29</volume><issue>3</issue><spage>311</spage><epage>320</epage><pages>311-320</pages><issn>1043-0679</issn><eissn>1532-9488</eissn><abstract>This study aims to analyze survival, repeat hospitalization, and risk factors for surgically treated left-sided endocarditis. Retrospective review of all 166 (114 native and 52 prosthetic) patients operated between January 2004 and March 2015 was performed. Long-term survival and repeat hospitalization data for 134 of 166 patients were obtained via linked clinical databases with the Manitoba Centre for Health Policy. Kaplan-Meier estimates of survival and hospital readmission and Cox multivariable regression analysis of factors influencing outcomes were performed. Survival at 1 and 5 years was 91% and 80%, respectively, and major adverse prosthesis-related event repeat hospitalization rates were 12% and 21%, respectively. Repeat hospitalization because of endocarditis was 7% and 11% at 1 and 5 years, respectively. Survival and repeat hospitalization were similar for aortic and mitral valves. Survival after surgically treated endocarditis was similar to survival for age-, sex-, and valve-matched surgical valve replacements for noninfectious indications (P = 0.53). Viridans Streptococci was the most common organism in native valve endocarditis, and culture negative endocarditis was most common in prosthetic valves. Prosthetic valve endocarditis (P < 0.01) and preoperative renal dysfunction (P < 0.01) were risk factors for in-hospital mortality and major postoperative adverse events. Diabetes and renal dysfunction were associated with poor long-term survival, functional survival, and repeat hospitalization. This analysis suggests that surgery remains a very effective tool in management of these complex patients in terms of survival and major adverse prosthesis-related event repeat hospitalization.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28935512</pmid><doi>10.1053/j.semtcvs.2017.08.002</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Seminars in thoracic and cardiovascular surgery, 2017, Vol.29 (3), p.311-320 |
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| subjects | Adult Aged Databases, Factual Endocarditis, Bacterial - diagnosis Endocarditis, Bacterial - microbiology Endocarditis, Bacterial - mortality Endocarditis, Bacterial - surgery Female Follow-Up Studies Heart Valve Prosthesis - adverse effects Heart Valve Prosthesis Implantation - adverse effects Heart Valve Prosthesis Implantation - instrumentation Heart Valve Prosthesis Implantation - mortality Hospital Mortality Humans infective endocarditis Kaplan-Meier Estimate left sided Logistic Models Longitudinal Studies Male Manitoba Middle Aged Multivariate Analysis outcomes Patient Readmission Postoperative Complications - mortality Postoperative Complications - therapy Proportional Hazards Models Prosthesis-Related Infections - diagnosis Prosthesis-Related Infections - microbiology Prosthesis-Related Infections - mortality Prosthesis-Related Infections - surgery Retrospective Studies Risk Factors surgical Time Factors Treatment Outcome |
| title | Analysis of Short- and Long-term Outcomes of Patients With Surgically Treated Left-sided Infective Endocarditis: A 5-Year Longitudinal Follow-up Study |
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