Prediction of Acute-phase Complications in Patients with Infectious Endocarditis
Objective Embolic events are frequent and life-threatening complications of infective endocarditis (IE). Recently, an embolic risk assessment at admission, based on the Embolic Risk (ER) French Calculator, was designed to predict the development of symptomatic emboli associated with IE. This study a...
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| Veröffentlicht in: | Internal Medicine 2019/08/15, Vol.58(16), pp.2323-2331 |
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| creator | Saito, Fumiya Toyoda, Shigeru Arikawa, Takuo Inami, Shu Watanabe, Ryo Obi, Syotaro Sakuma, Masashi Kanaya, Tomoaki Abe, Shichiro Nakajima, Toshiaki Inoue, Teruo |
| description | Objective Embolic events are frequent and life-threatening complications of infective endocarditis (IE). Recently, an embolic risk assessment at admission, based on the Embolic Risk (ER) French Calculator, was designed to predict the development of symptomatic emboli associated with IE. This study aimed to validate the ER French Calculator for the prediction of in-hospital events, including embolic events. Methods We retrospectively analyzed the clinical features of 52 consecutive patients with left-sided IE to identify possible predictors of in-hospital events within 30 days of admission. Results New embolic events were seen in 15 patients (29%), cardiac surgery was performed in 22 patients (42%), and 1 patient (2%) died within 30 days of admission. A composite endpoint of embolic complications, cardiac surgery, or death was observed in 28 patients (54%). The cumulative incidence of new embolic events was significantly higher in the high-risk group identified by the ER French Calculator than in the low-risk group (log-rank test; p=0.0004). The incidence of the composite endpoint was higher in the high-risk group than in the low-risk group (log-rank test; p |
| doi_str_mv | 10.2169/internalmedicine.1813-18 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6746645</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2276008356</sourcerecordid><originalsourceid>FETCH-LOGICAL-c610t-f1d08bbe18624d85d42d9344f79d5f785728b8f82d84ae29d61c033f5eb8e6313</originalsourceid><addsrcrecordid>eNplkU1v1DAQhi0EotvCX0CWuHBJ8UdiOxekalVopUrdA5wtx550vcrai-1Q8e9x2LKCchlbmmfe-XgRwpRcMir6jz4USMFMe3De-gCXVFHeUPUCrShv-0Yy3r1EK9JT1bAaztB5zjtCuJI9e43OOKVUcSFXaLNJi0bxMeA44is7F2gOW5MBr-P-MHlrllzGPuBN_UIoGT_6ssW3YYSlbs74OrhoTXK--PwGvRrNlOHt03uBvn2-_rq-ae7uv9yur-4aKygpzUgdUcMAVAnWOtW5lrmet-0oe9eNUnWSqUGNijnVGmC9E9QSzscOBgWCU36BPh11D_NQz2DrYMlM-pD83qSfOhqv_80Ev9UP8YcWshWi7arAhyeBFL_PkIve-2xhmkyAupRmjDNKBJOqou-fobs4L_dfKCkIUbwTlVJHyqaYc4LxNAwlerFNP7dNL7bVUEvf_b3MqfCPTxW4PwK7XMwDnACTircT_K_cKU3F73hscSLt1iQNgf8Ckgi3VA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2276008356</pqid></control><display><type>article</type><title>Prediction of Acute-phase Complications in Patients with Infectious Endocarditis</title><source>MEDLINE</source><source>PubMed Central Open Access</source><source>J-STAGE (Japan Science & Technology Information Aggregator, Electronic) Freely Available Titles - Japanese</source><source>PubMed Central</source><creator>Saito, Fumiya ; Toyoda, Shigeru ; Arikawa, Takuo ; Inami, Shu ; Watanabe, Ryo ; Obi, Syotaro ; Sakuma, Masashi ; Kanaya, Tomoaki ; Abe, Shichiro ; Nakajima, Toshiaki ; Inoue, Teruo</creator><creatorcontrib>Saito, Fumiya ; Toyoda, Shigeru ; Arikawa, Takuo ; Inami, Shu ; Watanabe, Ryo ; Obi, Syotaro ; Sakuma, Masashi ; Kanaya, Tomoaki ; Abe, Shichiro ; Nakajima, Toshiaki ; Inoue, Teruo</creatorcontrib><description>Objective Embolic events are frequent and life-threatening complications of infective endocarditis (IE). Recently, an embolic risk assessment at admission, based on the Embolic Risk (ER) French Calculator, was designed to predict the development of symptomatic emboli associated with IE. This study aimed to validate the ER French Calculator for the prediction of in-hospital events, including embolic events. Methods We retrospectively analyzed the clinical features of 52 consecutive patients with left-sided IE to identify possible predictors of in-hospital events within 30 days of admission. Results New embolic events were seen in 15 patients (29%), cardiac surgery was performed in 22 patients (42%), and 1 patient (2%) died within 30 days of admission. A composite endpoint of embolic complications, cardiac surgery, or death was observed in 28 patients (54%). The cumulative incidence of new embolic events was significantly higher in the high-risk group identified by the ER French Calculator than in the low-risk group (log-rank test; p=0.0004). The incidence of the composite endpoint was higher in the high-risk group than in the low-risk group (log-rank test; p<0.0001). A multivariate Cox proportional hazards model indicated that the high-risk designation on the ER French Calculator predicted embolic events (p=0.0410) and composite events (p=0.0371) independently of other candidate predictors. Conclusion The ER French Calculator may be a useful tool for predicting new in-hospital embolic events and other unfavorable in-hospital events in patients with IE.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.1813-18</identifier><identifier>PMID: 31118367</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>Adult ; Aged ; Aged, 80 and over ; cardiac surgery ; Cardiac Surgical Procedures - adverse effects ; Complications ; embolic event ; embolic risk ; Embolism - etiology ; Embolism - therapy ; Endocarditis ; Endocarditis, Bacterial - complications ; Endocarditis, Bacterial - surgery ; Female ; French Calculator ; Heart ; Heart surgery ; Humans ; Incidence ; infective endocarditis ; Internal medicine ; Japan ; Male ; Middle Aged ; Original ; Patients ; Proportional Hazards Models ; Rank tests ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Risk groups ; Statistical models</subject><ispartof>Internal Medicine, 2019/08/15, Vol.58(16), pp.2323-2331</ispartof><rights>2019 by The Japanese Society of Internal Medicine</rights><rights>Copyright Japan Science and Technology Agency 2019</rights><rights>Copyright © 2019 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c610t-f1d08bbe18624d85d42d9344f79d5f785728b8f82d84ae29d61c033f5eb8e6313</citedby><cites>FETCH-LOGICAL-c610t-f1d08bbe18624d85d42d9344f79d5f785728b8f82d84ae29d61c033f5eb8e6313</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746645/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746645/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,1883,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31118367$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saito, Fumiya</creatorcontrib><creatorcontrib>Toyoda, Shigeru</creatorcontrib><creatorcontrib>Arikawa, Takuo</creatorcontrib><creatorcontrib>Inami, Shu</creatorcontrib><creatorcontrib>Watanabe, Ryo</creatorcontrib><creatorcontrib>Obi, Syotaro</creatorcontrib><creatorcontrib>Sakuma, Masashi</creatorcontrib><creatorcontrib>Kanaya, Tomoaki</creatorcontrib><creatorcontrib>Abe, Shichiro</creatorcontrib><creatorcontrib>Nakajima, Toshiaki</creatorcontrib><creatorcontrib>Inoue, Teruo</creatorcontrib><title>Prediction of Acute-phase Complications in Patients with Infectious Endocarditis</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>Objective Embolic events are frequent and life-threatening complications of infective endocarditis (IE). Recently, an embolic risk assessment at admission, based on the Embolic Risk (ER) French Calculator, was designed to predict the development of symptomatic emboli associated with IE. This study aimed to validate the ER French Calculator for the prediction of in-hospital events, including embolic events. Methods We retrospectively analyzed the clinical features of 52 consecutive patients with left-sided IE to identify possible predictors of in-hospital events within 30 days of admission. Results New embolic events were seen in 15 patients (29%), cardiac surgery was performed in 22 patients (42%), and 1 patient (2%) died within 30 days of admission. A composite endpoint of embolic complications, cardiac surgery, or death was observed in 28 patients (54%). The cumulative incidence of new embolic events was significantly higher in the high-risk group identified by the ER French Calculator than in the low-risk group (log-rank test; p=0.0004). The incidence of the composite endpoint was higher in the high-risk group than in the low-risk group (log-rank test; p<0.0001). A multivariate Cox proportional hazards model indicated that the high-risk designation on the ER French Calculator predicted embolic events (p=0.0410) and composite events (p=0.0371) independently of other candidate predictors. Conclusion The ER French Calculator may be a useful tool for predicting new in-hospital embolic events and other unfavorable in-hospital events in patients with IE.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>cardiac surgery</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Complications</subject><subject>embolic event</subject><subject>embolic risk</subject><subject>Embolism - etiology</subject><subject>Embolism - therapy</subject><subject>Endocarditis</subject><subject>Endocarditis, Bacterial - complications</subject><subject>Endocarditis, Bacterial - surgery</subject><subject>Female</subject><subject>French Calculator</subject><subject>Heart</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>Incidence</subject><subject>infective endocarditis</subject><subject>Internal medicine</subject><subject>Japan</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Patients</subject><subject>Proportional Hazards Models</subject><subject>Rank tests</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Risk groups</subject><subject>Statistical models</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkU1v1DAQhi0EotvCX0CWuHBJ8UdiOxekalVopUrdA5wtx550vcrai-1Q8e9x2LKCchlbmmfe-XgRwpRcMir6jz4USMFMe3De-gCXVFHeUPUCrShv-0Yy3r1EK9JT1bAaztB5zjtCuJI9e43OOKVUcSFXaLNJi0bxMeA44is7F2gOW5MBr-P-MHlrllzGPuBN_UIoGT_6ssW3YYSlbs74OrhoTXK--PwGvRrNlOHt03uBvn2-_rq-ae7uv9yur-4aKygpzUgdUcMAVAnWOtW5lrmet-0oe9eNUnWSqUGNijnVGmC9E9QSzscOBgWCU36BPh11D_NQz2DrYMlM-pD83qSfOhqv_80Ev9UP8YcWshWi7arAhyeBFL_PkIve-2xhmkyAupRmjDNKBJOqou-fobs4L_dfKCkIUbwTlVJHyqaYc4LxNAwlerFNP7dNL7bVUEvf_b3MqfCPTxW4PwK7XMwDnACTircT_K_cKU3F73hscSLt1iQNgf8Ckgi3VA</recordid><startdate>20190815</startdate><enddate>20190815</enddate><creator>Saito, Fumiya</creator><creator>Toyoda, Shigeru</creator><creator>Arikawa, Takuo</creator><creator>Inami, Shu</creator><creator>Watanabe, Ryo</creator><creator>Obi, Syotaro</creator><creator>Sakuma, Masashi</creator><creator>Kanaya, Tomoaki</creator><creator>Abe, Shichiro</creator><creator>Nakajima, Toshiaki</creator><creator>Inoue, Teruo</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</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>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190815</creationdate><title>Prediction of Acute-phase Complications in Patients with Infectious Endocarditis</title><author>Saito, Fumiya ; Toyoda, Shigeru ; Arikawa, Takuo ; Inami, Shu ; Watanabe, Ryo ; Obi, Syotaro ; Sakuma, Masashi ; Kanaya, Tomoaki ; Abe, Shichiro ; Nakajima, Toshiaki ; Inoue, Teruo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c610t-f1d08bbe18624d85d42d9344f79d5f785728b8f82d84ae29d61c033f5eb8e6313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>cardiac surgery</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Complications</topic><topic>embolic event</topic><topic>embolic risk</topic><topic>Embolism - etiology</topic><topic>Embolism - therapy</topic><topic>Endocarditis</topic><topic>Endocarditis, Bacterial - complications</topic><topic>Endocarditis, Bacterial - surgery</topic><topic>Female</topic><topic>French Calculator</topic><topic>Heart</topic><topic>Heart surgery</topic><topic>Humans</topic><topic>Incidence</topic><topic>infective endocarditis</topic><topic>Internal medicine</topic><topic>Japan</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Patients</topic><topic>Proportional Hazards Models</topic><topic>Rank tests</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Risk groups</topic><topic>Statistical models</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saito, Fumiya</creatorcontrib><creatorcontrib>Toyoda, Shigeru</creatorcontrib><creatorcontrib>Arikawa, Takuo</creatorcontrib><creatorcontrib>Inami, Shu</creatorcontrib><creatorcontrib>Watanabe, Ryo</creatorcontrib><creatorcontrib>Obi, Syotaro</creatorcontrib><creatorcontrib>Sakuma, Masashi</creatorcontrib><creatorcontrib>Kanaya, Tomoaki</creatorcontrib><creatorcontrib>Abe, Shichiro</creatorcontrib><creatorcontrib>Nakajima, Toshiaki</creatorcontrib><creatorcontrib>Inoue, Teruo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saito, Fumiya</au><au>Toyoda, Shigeru</au><au>Arikawa, Takuo</au><au>Inami, Shu</au><au>Watanabe, Ryo</au><au>Obi, Syotaro</au><au>Sakuma, Masashi</au><au>Kanaya, Tomoaki</au><au>Abe, Shichiro</au><au>Nakajima, Toshiaki</au><au>Inoue, Teruo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prediction of Acute-phase Complications in Patients with Infectious Endocarditis</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2019-08-15</date><risdate>2019</risdate><volume>58</volume><issue>16</issue><spage>2323</spage><epage>2331</epage><pages>2323-2331</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>Objective Embolic events are frequent and life-threatening complications of infective endocarditis (IE). Recently, an embolic risk assessment at admission, based on the Embolic Risk (ER) French Calculator, was designed to predict the development of symptomatic emboli associated with IE. This study aimed to validate the ER French Calculator for the prediction of in-hospital events, including embolic events. Methods We retrospectively analyzed the clinical features of 52 consecutive patients with left-sided IE to identify possible predictors of in-hospital events within 30 days of admission. Results New embolic events were seen in 15 patients (29%), cardiac surgery was performed in 22 patients (42%), and 1 patient (2%) died within 30 days of admission. A composite endpoint of embolic complications, cardiac surgery, or death was observed in 28 patients (54%). The cumulative incidence of new embolic events was significantly higher in the high-risk group identified by the ER French Calculator than in the low-risk group (log-rank test; p=0.0004). The incidence of the composite endpoint was higher in the high-risk group than in the low-risk group (log-rank test; p<0.0001). A multivariate Cox proportional hazards model indicated that the high-risk designation on the ER French Calculator predicted embolic events (p=0.0410) and composite events (p=0.0371) independently of other candidate predictors. Conclusion The ER French Calculator may be a useful tool for predicting new in-hospital embolic events and other unfavorable in-hospital events in patients with IE.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>31118367</pmid><doi>10.2169/internalmedicine.1813-18</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over cardiac surgery Cardiac Surgical Procedures - adverse effects Complications embolic event embolic risk Embolism - etiology Embolism - therapy Endocarditis Endocarditis, Bacterial - complications Endocarditis, Bacterial - surgery Female French Calculator Heart Heart surgery Humans Incidence infective endocarditis Internal medicine Japan Male Middle Aged Original Patients Proportional Hazards Models Rank tests Retrospective Studies Risk Assessment Risk Factors Risk groups Statistical models |
| title | Prediction of Acute-phase Complications in Patients with Infectious Endocarditis |
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