دورية أكاديمية
Long-term outcomes and cardiac surgery in critically ill patients with infective endocarditis
| العنوان: | Long-term outcomes and cardiac surgery in critically ill patients with infective endocarditis |
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| المؤلفون: | Mirabel, Mariana, Sonneville, Romain, Hajage, David, Novy, Emmanuel, Tubach, Florence, Vignon, Philippe, Perez, Pierre, Lavoué, Sylvain, Kouatchet, Achille, Pajot, Olivier, Mekontso-Dessap, Armand, Tonnelier, Jean-Marie, Bollaert, Pierre-Edouard, Frat, Jean-Pierre, Navellou, Jean-Christophe, Hyvernat, Herve, Hssain, Ali Ait, Timsit, Jean-François, Megarbane, Bruno, Wolff, Michel, Trouillet, Jean-Louis, for the ENDOREA Study Group |
| بيانات النشر: | Oxford University Press |
| سنة النشر: | 2014 |
| المجموعة: | HighWire Press (Stanford University) |
| مصطلحات موضوعية: | Endocarditis |
| الوصف: | Aims To assess long-term outcomes and the management of critical left-sided infective endocarditis (IE) and evaluate the impact of surgery. Methods and results Among the 198 patients included prospectively for IE across 33 adult intensive care units (ICU) in France from 1 April 2007 to 1 October 2008, 137 (69%) were dead at a median follow-up time of 59.5 months. Characteristics significantly associated with mortality were: Sepsis-related Organ-Failure Assessment (SOFA) score at ICU admission [Hazard ratio (HR), 95% Confidence Interval (CI) of 1.43 (0.79–2.59) for SOFA 5–9; 2.01 (1.05–3.85) for SOFA 10–14; 3.53 (1.75–7.11) for SOFA 15–20; reference category SOFA 0–4; P = 0.003]; prosthetic mechanical valve IE [HR 2.01; 95% CI 1.09–3.69, P = 0.025]; vegetation size ≥15 mm [HR 1.64; 95% CI 1.03–2.63, P = 0.038]; and cardiac surgery [HR (95%CI), 0.33 (0.16–0.67) for surgery ≤1 day after IE diagnosis; 0.61 (0.29–1.26) for surgery 2–7 days after IE diagnosis; 0.42 (0.21–0.83) for surgery >7 days after IE diagnosis; reference category no surgery; P = 0.005]. One hundred and three (52%) patients underwent cardiac surgery after a median time of 6 (16) days. Independent predictors of surgical intervention on multivariate analysis were: age ≤60 years [Odds ratio (OR) 5.30; 95% CI (2.46–11.41), P < 0.01], heart failure [OR 3.27; 95% CI (1.03–10.35), P = 0.04], cardiogenic shock [OR 3.31; 95% CI (1.47–7.46), P = 0.004], septic shock [OR 0.25; 95% CI (0.11–0.59), P = 0.002], immunosuppression [OR 0.15; 95% CI (0.04–0.55), P = 0.004], and diagnosis before or within 24 h of ICU admission [OR 2.81; 95% CI (1.14–6.95), P = 0.025]. SOFA score calculated the day of surgery was the only independently associated factor with long-term mortality [HR (95% CI) 1.59 (0.77–3.28) for SOFA 5–9; 3.56 (1.71–7.38) for SOFA 10–14; 11.58 (4.02–33.35) for SOFA 15–20; reference category SOFA 0–4; P < 0.0001]. Surgical timing was not associated with post-operative outcomes. Of the 158 patients with a theoretical indication for surgery, the ... |
| نوع الوثيقة: | text |
| وصف الملف: | text/html |
| اللغة: | English |
| العلاقة: | http://eurheartj.oxfordjournals.org/cgi/content/short/35/18/1195Test; http://dx.doi.org/10.1093/eurheartj/eht303Test |
| DOI: | 10.1093/eurheartj/eht303 |
| الإتاحة: | https://doi.org/10.1093/eurheartj/eht303Test http://eurheartj.oxfordjournals.org/cgi/content/short/35/18/1195Test |
| حقوق: | Copyright (C) 2014, European Society of Cardiology |
| رقم الانضمام: | edsbas.C9EB65ED |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/eurheartj/eht303 |
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