Prognostic factors of mortality after surgery in infective endocarditis: systematic review and meta-analysis

Barca, L; Elorza, Enrique Navas; Fernández-Hidalgo, Núria; Mur, José Luis Moya; Muriel, Alfonso; Fernández-Félix, Borja M.; Hycka, Javier Miguelena; Rodríguez-Roda, Jorge; López-Menéndez, José

doi:10.1007/s15010-019-01338-x

Cited by 31 publications

(11 citation statements)

References 65 publications

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“…This real-world data validates the increased surgical risk in women with IE, which is already considered in the above-mentioned risk scores. The higher surgical susceptibility of women was also found by Curlier et al 23 and in a recent meta-analysis by Varela et al 33 Weber et al 22 concluded that a higher postoperative mortality rate in women was due to the presence of more comorbidities and perioperative risk factors, which was apparently not the case in the current study. This higher mortality after surgery in the female sex was also noted in other fields of cardiac surgery, such as after coronary artery bypass graft surgery.…”

Section: Discussionsupporting

confidence: 75%

Gender Based Analysis of a Population Series of Patients Hospitalized with Infective Endocarditis in Portugal – How do Women and Men Compare?

Sousa¹,

Nogueira²,

Pinto³

2021

International Journal of Cardiovascular Sciences

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Cardiovascular diseases, including coronary heart disease, heart failure, and cerebrovascular disease, constitute leading causes of cardiovascular morbidity and mortality worldwide. 1 Great advances in cardiovascular prevention and management 2-4 have dramatically altered the outcome of these patients. Still, this trend has not been homogeneous between men and women. In the last decades, a growing awareness of the similarities and differences between men and women regarding cardiovascular function, disease burden, and epidemiology has been noted. Several initiatives issued by scientific societies have increasingly

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Section: Discussionsupporting

confidence: 75%

Gender Based Analysis of a Population Series of Patients Hospitalized with Infective Endocarditis in Portugal – How do Women and Men Compare?

Sousa¹,

Nogueira²,

Pinto³

2021

International Journal of Cardiovascular Sciences

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“…In a meta-analysis, including 16 studies examining risk scores for the assessment of in-hospital mortality in patients undergoing surgical treatment for IE, age, among other factors, was found to be associated with an increased risk of in-hospital mortality [ 16 ]. Further, age is included as a predictor in several surgical risk scores used for IE [ 17 – 20 ] but little data are present on the prognosis for IE patients > 75 years of age.…”

Section: Introductionmentioning

confidence: 99%

Differences in mortality in patients undergoing surgery for infective endocarditis according to age and valvular surgery

et al. 2020

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Background Infective endocarditis (IE) is associated with high mortality. Surgery may improve survival and reduce complications, but the balance between benefit and harm is difficult and may be closely related to age and type of surgical intervention. We aimed to examine how age and type of left-sided surgical intervention modified mortality in patients undergoing surgery for IE. Methods By crosslinking nationwide Danish registries we identified patients with first-time IE undergoing surgical treatment 2000–2017. Patients were grouped by age < 60 years, 60–75 years, and ≥ 75 years. Multivariable adjusted Cox proportional hazard analysis was used to examine factors associated with 90-day mortality. Results We included 1767 patients with IE undergoing surgery, 735 patients < 60 years (24.1% female), 766 patients 60–75 years (25.8% female), and 266 patients ≥75 years (36.1% female). The proportions of patients undergoing surgery were 35.3, 26.9, and 9.1% for patients < 60 years, 60–75 years, and > 75 years, respectively. Mortality at 90 days were 7.5, 13.9, and 22.3% (p < 0.001) for three age groups. In adjusted analyses, patients 60–75 years and patients ≥75 years were associated with a higher mortality, HR = 1.84 (95% CI: 1.48–2.29) and HR = 2.47 (95% CI: 1.88–3.24) as compared with patients < 60 years. Factors associated with 90-day mortality were: mitral valve surgery, a combination of mitral and aortic valve surgery as compared with isolated aortic valve surgery, age, diabetes, and prosthetic heart valve implantation prior to IE admission. Conclusions In patients undergoing surgery for IE, mortality increased significantly with age and 1 in 5 died above age 75 years. Mitral valve surgery as well as multiple valve interventions augmented mortality further.

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“…Due to the high fatality rate and complexity of the preoperative condition of IE, many studies have been conducted on patient characteristics to explore their impact on poor outcomes. A meta-analysis of 16 studies with a total of 7,484 patients showed that many characteristics and complications were important risk factors for early postoperative death, including age, female sex, urgent or emergency surgery, previous cardiac surgery, NYHA ≥III, cardiogenic shock, prosthetic valve, multivalvular affection, renal failure, paravalvular abscess and S. aureus infection (5).…”

Section: Discussionmentioning

confidence: 99%

“…However, for patients who require surgery, preoperative evaluations are intricate. Several studies have identified numerous risk factors for the prognosis of IE, including age, urgent or emergency surgery, multivalvular affection, renal failure, and staph aureus infection (5). However, in the past 2 decades, there has been no significant improvement in the survival rate of IE (6), which indicates that many details still need to be optimized in the preoperative assessment and management of IE.…”

Section: Introductionmentioning

confidence: 99%

Preoperative serum albumin: a promising indicator of early mortality after surgery for infective endocarditis

Huang¹,

Zhou²,

Luo³

et al. 2021

Ann Transl Med

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Background: Despite novel improvements in the diagnosis and treatment of infective endocarditis (IE), there has been no significant improvement in the survival rate of IE, which indicates that many details still need to be optimized in the preoperative assessment. We sought to evaluate preoperative serum albumin as a biomarker for predicting early mortality after IE surgery.Methods: Between October 2013 and June 2019, patients with a definite diagnosis of IE were enrolled in this study. Patients' albumin levels at admission were used as the preoperative albumin levels. Restricted cubic spline and multivariate logistic regression analyses were performed to evaluate the relationship between albumin and early mortality. Receiver operating characteristic curve analyses were performed to assess the role of albumin in predicting early mortality and compare the predictive capacity of traditional models with models that included albumin. Results: Of the 276 IE patients, 20 (7.2%) died in hospital or within 30 days of surgery. Hypoalbuminemia (an albumin level <3.5 g/dL) was present in 109 (39.5%) patients. The multivariate logistic regression analysis showed that preoperative albumin was inversely associated with early mortality [adjusted odds ratio (OR) =0.22 per 1 g/dL, 95% confidence interval (CI): 0.07-0.65, P=0.006] after full adjustment. Preoperative albumin had value in predicting early mortality [area under the curve (AUC) =0.72, 95% CI: 0.61-0.84; P<0.01]. After adding albumin to the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and Charlson score, the predictive ability of the model was further improved (EuroSCORE II: AUC =0.55;

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Prognostic factors of mortality after surgery in infective endocarditis: systematic review and meta-analysis

Cited by 31 publications

References 65 publications

Gender Based Analysis of a Population Series of Patients Hospitalized with Infective Endocarditis in Portugal – How do Women and Men Compare?

Gender Based Analysis of a Population Series of Patients Hospitalized with Infective Endocarditis in Portugal – How do Women and Men Compare?

Differences in mortality in patients undergoing surgery for infective endocarditis according to age and valvular surgery

Preoperative serum albumin: a promising indicator of early mortality after surgery for infective endocarditis

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