Back to Search
Start Over
Valve surgery in active infective endocarditis: a simple score to predict in-hospital prognosis
- Source :
- International journal of cardiology. 175(1)
- Publication Year :
- 2014
-
Abstract
- Aims Surgery for infective endocarditis (IE) is associated with high mortality. Our objectives were to describe the experience with surgical treatment for IE in Spain, and to identify predictors of in-hospital mortality. Methods Prospective cohort of 1000 consecutive patients with IE. Data were collected in 26 Spanish hospitals. Results Surgery was performed in 437 patients (43.7%). Patients treated with surgery were younger and predominantly male. They presented fewer comorbid conditions and more often had negative blood cultures and heart failure. In-hospital mortality after surgery was lower than in the medical therapy group (24.3 vs 30.7%, p = 0.02). In patients treated with surgery, endocarditis involved a native valve in 267 patients (61.1%), a prosthetic valve in 122 (27.9%), and a pacemaker lead with no clear further valve involvement in 48 (11.0%). The most common aetiologies were Staphylococcus (186, 42.6%), Streptococcus (97, 22.2%), and Enterococcus (49, 11.2%). The main indications for surgery were heart failure and severe valve regurgitation. A risk score for in-hospital mortality was developed using 7 prognostic variables with a similar predictive value (OR between 1.7 and 2.3): PALSUSE: prosthetic valve, age ≥ 70, large intracardiac destruction, Staphylococcus spp, urgent surgery, sex [female], EuroSCORE ≥ 10. In-hospital mortality ranged from 0% in patients with a PALSUSE score of 0 to 45.4% in patients with PALSUSE score > 3. Conclusions The prognosis of IE surgery is highly variable. The PALSUSE score could help to identify patients with higher in-hospital mortality. 4.036 JCR (2014) Q1, 29/123 Cardiac and cardiovascular systems UEM
- Subjects :
- Male
Prognostic variable
medicine.medical_specialty
Regurgitation (circulation)
Cardiología
Severity of Illness Index
Intracardiac injection
Cohort Studies
Predictive Value of Tests
Medicine
Endocarditis
Humans
Hospital Mortality
Prospective Studies
Prospective cohort study
Sistema cardiovascular
Aged
Aged, 80 and over
Heart Valve Prosthesis Implantation
Endocarditis infecciosa
Framingham Risk Score
business.industry
Endocarditis, Bacterial
Middle Aged
Estratificación de riesgos
medicine.disease
Surgery
Heart failure
Infective endocarditis
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 18741754
- Volume :
- 175
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- International journal of cardiology
- Accession number :
- edsair.doi.dedup.....d3ec4d95eab1068e2b93e1d1645e28a1