TY - JOUR
T1 - Risk factors associated with mortality in the infective endocarditis patients requiring cardiac surgery
T2 - a study based on Latvian population
AU - Meidrops, Kristiāns
AU - Osipovs, Janis Davis
AU - Zuravlova, Arina
AU - Groma, Valērija
AU - Kalējs, Mārtiņš
AU - Petrošina, Eva
AU - Leibuss, Roberts
AU - Strīķe, Eva
AU - Dumpis, Uga
AU - Erglis, Andrejs
AU - Stradiņš, Pēteris
N1 - Publisher Copyright:
© 2022 EDIZIONI MINERVA MEDICA.
PY - 2022/8
Y1 - 2022/8
N2 - BACKGROUND: Increased life expectancy, developments in medicine and intracardiac devices, accessibility of cardiac surgery, decrease in the prevalence of rheumatic heart disease are changing infective endocarditis patient profile and thus risk factors for the adverse events. This single-center-based study covering the whole Latvian population aimed to assess the intrahospital and 3-year mortality of infective endocarditis patients who underwent cardiac surgery, as well as risk factors and laboratory indices predictive of adverse outcomes of the disease. METHODS: Clinical profiles, data of laboratory and instrumental analyses, operation and intensive care unit records of cardiac surgery patients treated in Pauls Stradins Clinical University Hospital, Riga, Latvia, between 2015 and 2019 were analyzed. RESULTS: We analyzed data from 242 episodes of surgically treated infective endocarditis in 233 patients. The median age of patients was 57.00 (45.00-68.00) years. The rate of intrahospital mortality was 11.16%. Risk factors associated with mortality in the univariate analyses were S. aureus infection (HR=2.27, 95% CI: 1.36-3.80; P=0.002) and systemic embolization of vegetations (HR=1.63, 95% CI: 1.00-2.64; P=0.048). Perivalvular complications (HR=1.98, 95% CI: 1.19-3.29; P=0.009) were found to be independently associated with mortality in multivariate analysis (HR=1.99, 95% CI: 1.05-3.78; P=0.035). One-year survival was 78.3%, whereas three-year -71.3%. CONCLUSIONS: Intrahospital mortality of surgically treated IE patients was 11.2%; however, one- and three-year mortality was 21.7 and 28.7%, respectively. Perivalvular complications were independently associated with mortality. Laboratory indices were not predictive of adverse outcomes.
AB - BACKGROUND: Increased life expectancy, developments in medicine and intracardiac devices, accessibility of cardiac surgery, decrease in the prevalence of rheumatic heart disease are changing infective endocarditis patient profile and thus risk factors for the adverse events. This single-center-based study covering the whole Latvian population aimed to assess the intrahospital and 3-year mortality of infective endocarditis patients who underwent cardiac surgery, as well as risk factors and laboratory indices predictive of adverse outcomes of the disease. METHODS: Clinical profiles, data of laboratory and instrumental analyses, operation and intensive care unit records of cardiac surgery patients treated in Pauls Stradins Clinical University Hospital, Riga, Latvia, between 2015 and 2019 were analyzed. RESULTS: We analyzed data from 242 episodes of surgically treated infective endocarditis in 233 patients. The median age of patients was 57.00 (45.00-68.00) years. The rate of intrahospital mortality was 11.16%. Risk factors associated with mortality in the univariate analyses were S. aureus infection (HR=2.27, 95% CI: 1.36-3.80; P=0.002) and systemic embolization of vegetations (HR=1.63, 95% CI: 1.00-2.64; P=0.048). Perivalvular complications (HR=1.98, 95% CI: 1.19-3.29; P=0.009) were found to be independently associated with mortality in multivariate analysis (HR=1.99, 95% CI: 1.05-3.78; P=0.035). One-year survival was 78.3%, whereas three-year -71.3%. CONCLUSIONS: Intrahospital mortality of surgically treated IE patients was 11.2%; however, one- and three-year mortality was 21.7 and 28.7%, respectively. Perivalvular complications were independently associated with mortality. Laboratory indices were not predictive of adverse outcomes.
KW - Complications
KW - Endocarditis
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=85134721001&partnerID=8YFLogxK
U2 - 10.23736/S0021-9509.22.12092-6
DO - 10.23736/S0021-9509.22.12092-6
M3 - Article
C2 - 35343659
AN - SCOPUS:85134721001
SN - 0021-9509
VL - 63
SP - 507
EP - 513
JO - Journal of Cardiovascular Surgery
JF - Journal of Cardiovascular Surgery
IS - 4
ER -