Highlights
- •Timing of clinical complications impacts prognosis in LSIE.
- •Renal failure and septic shock after surgery are the strongest predictors.
- •In hospital mortality of LSIE depends mainly on clinical evolution after surgery.
- •Prognostic reassessment after surgery for LSIE is mandatory.
Abstract
Background
Left-sided infective endocarditis (LSIE) bears a grim prognosis and surgery is needed
in more than half of the patients to improve survival. Our hypothesis has been that
clinical complications developing after surgery impact prognosis.
Methods
Among 1075 consecutive episodes of LSIE, 654 (60.7%) underwent cardiac surgery. Of
them, 41 patients (6.3%) died the same day of surgery, 112 (17.2%) died after the
first day of surgery during hospital stay and 500 (76.5%) were successfully discharged.
We compared the last two groups and performed a multivariable analysis of in-hospital
mortality.
Results
Age (OR 1.02, 95% CI 1.01–1.04), periannular complications (OR 1.9, 95% CI 1.2–3.2)
renal failure after surgery (OR 2.4, 95% CI 1.3–4.4) but not before surgery, and septic
shock after surgery (OR 9.6, 95% CI 5.4–17.1) but not before surgery are predictive
of in-hospital death among LSIE patients who underwent cardiac surgery.
Conclusion
A thorough clinical assessment with prognostic purposes in infective endocarditis
after surgery is mandatory. In-hospital mortality of patients with infective endocarditis
who undergo surgery depends mainly on the clinical evolution after surgery.
Keywords
Abbreviations:
LSIE (Left-sided infective endocarditis), IE (Infective endocarditis), OR (Odds ratio)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 29, 2018
Accepted:
May 25,
2018
Received in revised form:
May 21,
2018
Received:
November 30,
2017
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
