Native infective endocarditis: Which determinants of outcome remain after surgical treatment?
Summary Surgical therapy of native infective endocarditis is still considered as a particular challenge, due to remaining morbidity and mortality up to 20%. Further risk analysis and characterization of clinical features is of great importance for further improvement of surgical results. The aim of...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Tugtekin, Sems Malte [verfasserIn] Alexiou, Konstantin [verfasserIn] Wilbring, Manuel [verfasserIn] Daubner, Dirk [verfasserIn] Kappert, Utz [verfasserIn] Knaut, Michael [verfasserIn] Matschke, Klaus [verfasserIn] |
|---|
| Format: |
E-Artikel |
|---|---|
| Sprache: |
Englisch |
| Erschienen: |
2006 |
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| Übergeordnetes Werk: |
Enthalten in: Zeitschrift für Kardiologie - Darmstadt : Steinkopff, 1997, 95(2006), 2 vom: 16. Jan., Seite 72-79 |
|---|---|
| Übergeordnetes Werk: |
volume:95 ; year:2006 ; number:2 ; day:16 ; month:01 ; pages:72-79 |
| Links: |
|---|
| DOI / URN: |
10.1007/s00392-006-0326-6 |
|---|
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SPR004797264 |
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| 520 | |a Summary Surgical therapy of native infective endocarditis is still considered as a particular challenge, due to remaining morbidity and mortality up to 20%. Further risk analysis and characterization of clinical features is of great importance for further improvement of surgical results. The aim of this retrospective study was a risk analysis concerning clinical features of the pre–, intra– and postoperative period. Between 02/1997 and 12/2003, 165 patients (130 male, 35 female, age 55.5 ± 13.8 years) were referred for surgical therapy of infective endocarditis at our institution. Preoperative, intraoperative and postoperative features were evaluated for their influence on the early postoperative course and the mid–term follow–up. In the majority of patients (pts) the aortic valve was infected (n = 83, 50.3% of pts), followed by mitral valve (n = 33; 20.0%), tricuspid valve (n = 10, 6.0%) and pulmonary valve (n = 2; 1.2%). Double valve affection was recorded in 37 pts (22.4%). Streptococci (n = 66, 40.0%) and staphylococci (n = 66, 40.0%) were the most common pathogens. The overall hospital mortality rate was 10.9% (n = 18), during follow–up (mean follow–up 3.3 ± 2.5 years) a further 20 pts (12.1%) died. Main predictors for hospital mortality in multivariate analysis were older age (p = 0.01), prolonged ICU stay, prolonged intubation (p = 0.03; p = 0.02) and the continuous postoperative need of alpha–catecholamine medication (p < 0.01). Significant predictors of overall mortality were older age (> 70 years) and diabetes (p = 0.03; p = 0.03). Reinfection occurred in 6.1% of patients (n = 10). Actuarial freedom from recurrent infection was 97% at 1 year and 93.9% at 5 years. Surgical therapy of infective endocarditis is associated with good clinical results in the early and mid–term follow–up. Predictors of outcome particular include preoperative risk constellation or comorbidity (age, diabetes) and variables of the immediate postoperative course. | ||
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10.1007/s00392-006-0326-6 doi (DE-627)SPR004797264 (SPR)s00392-006-0326-6-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.67 bkl 44.85 bkl Tugtekin, Sems Malte verfasserin aut Native infective endocarditis: Which determinants of outcome remain after surgical treatment? 2006 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary Surgical therapy of native infective endocarditis is still considered as a particular challenge, due to remaining morbidity and mortality up to 20%. Further risk analysis and characterization of clinical features is of great importance for further improvement of surgical results. The aim of this retrospective study was a risk analysis concerning clinical features of the pre–, intra– and postoperative period. Between 02/1997 and 12/2003, 165 patients (130 male, 35 female, age 55.5 ± 13.8 years) were referred for surgical therapy of infective endocarditis at our institution. Preoperative, intraoperative and postoperative features were evaluated for their influence on the early postoperative course and the mid–term follow–up. In the majority of patients (pts) the aortic valve was infected (n = 83, 50.3% of pts), followed by mitral valve (n = 33; 20.0%), tricuspid valve (n = 10, 6.0%) and pulmonary valve (n = 2; 1.2%). Double valve affection was recorded in 37 pts (22.4%). Streptococci (n = 66, 40.0%) and staphylococci (n = 66, 40.0%) were the most common pathogens. The overall hospital mortality rate was 10.9% (n = 18), during follow–up (mean follow–up 3.3 ± 2.5 years) a further 20 pts (12.1%) died. Main predictors for hospital mortality in multivariate analysis were older age (p = 0.01), prolonged ICU stay, prolonged intubation (p = 0.03; p = 0.02) and the continuous postoperative need of alpha–catecholamine medication (p < 0.01). Significant predictors of overall mortality were older age (> 70 years) and diabetes (p = 0.03; p = 0.03). Reinfection occurred in 6.1% of patients (n = 10). Actuarial freedom from recurrent infection was 97% at 1 year and 93.9% at 5 years. Surgical therapy of infective endocarditis is associated with good clinical results in the early and mid–term follow–up. Predictors of outcome particular include preoperative risk constellation or comorbidity (age, diabetes) and variables of the immediate postoperative course. Alexiou, Konstantin verfasserin aut Wilbring, Manuel verfasserin aut Daubner, Dirk verfasserin aut Kappert, Utz verfasserin aut Knaut, Michael verfasserin aut Matschke, Klaus verfasserin aut Enthalten in Zeitschrift für Kardiologie Darmstadt : Steinkopff, 1997 95(2006), 2 vom: 16. Jan., Seite 72-79 (DE-627)254911137 (DE-600)1463330-9 1435-1285 nnns volume:95 year:2006 number:2 day:16 month:01 pages:72-79 https://dx.doi.org/10.1007/s00392-006-0326-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 44.67 ASE 44.85 ASE AR 95 2006 2 16 01 72-79 |
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10.1007/s00392-006-0326-6 doi (DE-627)SPR004797264 (SPR)s00392-006-0326-6-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.67 bkl 44.85 bkl Tugtekin, Sems Malte verfasserin aut Native infective endocarditis: Which determinants of outcome remain after surgical treatment? 2006 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary Surgical therapy of native infective endocarditis is still considered as a particular challenge, due to remaining morbidity and mortality up to 20%. Further risk analysis and characterization of clinical features is of great importance for further improvement of surgical results. The aim of this retrospective study was a risk analysis concerning clinical features of the pre–, intra– and postoperative period. Between 02/1997 and 12/2003, 165 patients (130 male, 35 female, age 55.5 ± 13.8 years) were referred for surgical therapy of infective endocarditis at our institution. Preoperative, intraoperative and postoperative features were evaluated for their influence on the early postoperative course and the mid–term follow–up. In the majority of patients (pts) the aortic valve was infected (n = 83, 50.3% of pts), followed by mitral valve (n = 33; 20.0%), tricuspid valve (n = 10, 6.0%) and pulmonary valve (n = 2; 1.2%). Double valve affection was recorded in 37 pts (22.4%). Streptococci (n = 66, 40.0%) and staphylococci (n = 66, 40.0%) were the most common pathogens. The overall hospital mortality rate was 10.9% (n = 18), during follow–up (mean follow–up 3.3 ± 2.5 years) a further 20 pts (12.1%) died. Main predictors for hospital mortality in multivariate analysis were older age (p = 0.01), prolonged ICU stay, prolonged intubation (p = 0.03; p = 0.02) and the continuous postoperative need of alpha–catecholamine medication (p < 0.01). Significant predictors of overall mortality were older age (> 70 years) and diabetes (p = 0.03; p = 0.03). Reinfection occurred in 6.1% of patients (n = 10). Actuarial freedom from recurrent infection was 97% at 1 year and 93.9% at 5 years. Surgical therapy of infective endocarditis is associated with good clinical results in the early and mid–term follow–up. Predictors of outcome particular include preoperative risk constellation or comorbidity (age, diabetes) and variables of the immediate postoperative course. Alexiou, Konstantin verfasserin aut Wilbring, Manuel verfasserin aut Daubner, Dirk verfasserin aut Kappert, Utz verfasserin aut Knaut, Michael verfasserin aut Matschke, Klaus verfasserin aut Enthalten in Zeitschrift für Kardiologie Darmstadt : Steinkopff, 1997 95(2006), 2 vom: 16. Jan., Seite 72-79 (DE-627)254911137 (DE-600)1463330-9 1435-1285 nnns volume:95 year:2006 number:2 day:16 month:01 pages:72-79 https://dx.doi.org/10.1007/s00392-006-0326-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 44.67 ASE 44.85 ASE AR 95 2006 2 16 01 72-79 |
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10.1007/s00392-006-0326-6 doi (DE-627)SPR004797264 (SPR)s00392-006-0326-6-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.67 bkl 44.85 bkl Tugtekin, Sems Malte verfasserin aut Native infective endocarditis: Which determinants of outcome remain after surgical treatment? 2006 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary Surgical therapy of native infective endocarditis is still considered as a particular challenge, due to remaining morbidity and mortality up to 20%. Further risk analysis and characterization of clinical features is of great importance for further improvement of surgical results. The aim of this retrospective study was a risk analysis concerning clinical features of the pre–, intra– and postoperative period. Between 02/1997 and 12/2003, 165 patients (130 male, 35 female, age 55.5 ± 13.8 years) were referred for surgical therapy of infective endocarditis at our institution. Preoperative, intraoperative and postoperative features were evaluated for their influence on the early postoperative course and the mid–term follow–up. In the majority of patients (pts) the aortic valve was infected (n = 83, 50.3% of pts), followed by mitral valve (n = 33; 20.0%), tricuspid valve (n = 10, 6.0%) and pulmonary valve (n = 2; 1.2%). Double valve affection was recorded in 37 pts (22.4%). Streptococci (n = 66, 40.0%) and staphylococci (n = 66, 40.0%) were the most common pathogens. The overall hospital mortality rate was 10.9% (n = 18), during follow–up (mean follow–up 3.3 ± 2.5 years) a further 20 pts (12.1%) died. Main predictors for hospital mortality in multivariate analysis were older age (p = 0.01), prolonged ICU stay, prolonged intubation (p = 0.03; p = 0.02) and the continuous postoperative need of alpha–catecholamine medication (p < 0.01). Significant predictors of overall mortality were older age (> 70 years) and diabetes (p = 0.03; p = 0.03). Reinfection occurred in 6.1% of patients (n = 10). Actuarial freedom from recurrent infection was 97% at 1 year and 93.9% at 5 years. Surgical therapy of infective endocarditis is associated with good clinical results in the early and mid–term follow–up. Predictors of outcome particular include preoperative risk constellation or comorbidity (age, diabetes) and variables of the immediate postoperative course. Alexiou, Konstantin verfasserin aut Wilbring, Manuel verfasserin aut Daubner, Dirk verfasserin aut Kappert, Utz verfasserin aut Knaut, Michael verfasserin aut Matschke, Klaus verfasserin aut Enthalten in Zeitschrift für Kardiologie Darmstadt : Steinkopff, 1997 95(2006), 2 vom: 16. Jan., Seite 72-79 (DE-627)254911137 (DE-600)1463330-9 1435-1285 nnns volume:95 year:2006 number:2 day:16 month:01 pages:72-79 https://dx.doi.org/10.1007/s00392-006-0326-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 44.67 ASE 44.85 ASE AR 95 2006 2 16 01 72-79 |
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10.1007/s00392-006-0326-6 doi (DE-627)SPR004797264 (SPR)s00392-006-0326-6-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.67 bkl 44.85 bkl Tugtekin, Sems Malte verfasserin aut Native infective endocarditis: Which determinants of outcome remain after surgical treatment? 2006 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary Surgical therapy of native infective endocarditis is still considered as a particular challenge, due to remaining morbidity and mortality up to 20%. Further risk analysis and characterization of clinical features is of great importance for further improvement of surgical results. The aim of this retrospective study was a risk analysis concerning clinical features of the pre–, intra– and postoperative period. Between 02/1997 and 12/2003, 165 patients (130 male, 35 female, age 55.5 ± 13.8 years) were referred for surgical therapy of infective endocarditis at our institution. Preoperative, intraoperative and postoperative features were evaluated for their influence on the early postoperative course and the mid–term follow–up. In the majority of patients (pts) the aortic valve was infected (n = 83, 50.3% of pts), followed by mitral valve (n = 33; 20.0%), tricuspid valve (n = 10, 6.0%) and pulmonary valve (n = 2; 1.2%). Double valve affection was recorded in 37 pts (22.4%). Streptococci (n = 66, 40.0%) and staphylococci (n = 66, 40.0%) were the most common pathogens. The overall hospital mortality rate was 10.9% (n = 18), during follow–up (mean follow–up 3.3 ± 2.5 years) a further 20 pts (12.1%) died. Main predictors for hospital mortality in multivariate analysis were older age (p = 0.01), prolonged ICU stay, prolonged intubation (p = 0.03; p = 0.02) and the continuous postoperative need of alpha–catecholamine medication (p < 0.01). Significant predictors of overall mortality were older age (> 70 years) and diabetes (p = 0.03; p = 0.03). Reinfection occurred in 6.1% of patients (n = 10). Actuarial freedom from recurrent infection was 97% at 1 year and 93.9% at 5 years. Surgical therapy of infective endocarditis is associated with good clinical results in the early and mid–term follow–up. Predictors of outcome particular include preoperative risk constellation or comorbidity (age, diabetes) and variables of the immediate postoperative course. Alexiou, Konstantin verfasserin aut Wilbring, Manuel verfasserin aut Daubner, Dirk verfasserin aut Kappert, Utz verfasserin aut Knaut, Michael verfasserin aut Matschke, Klaus verfasserin aut Enthalten in Zeitschrift für Kardiologie Darmstadt : Steinkopff, 1997 95(2006), 2 vom: 16. Jan., Seite 72-79 (DE-627)254911137 (DE-600)1463330-9 1435-1285 nnns volume:95 year:2006 number:2 day:16 month:01 pages:72-79 https://dx.doi.org/10.1007/s00392-006-0326-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 44.67 ASE 44.85 ASE AR 95 2006 2 16 01 72-79 |
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10.1007/s00392-006-0326-6 doi (DE-627)SPR004797264 (SPR)s00392-006-0326-6-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.67 bkl 44.85 bkl Tugtekin, Sems Malte verfasserin aut Native infective endocarditis: Which determinants of outcome remain after surgical treatment? 2006 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary Surgical therapy of native infective endocarditis is still considered as a particular challenge, due to remaining morbidity and mortality up to 20%. Further risk analysis and characterization of clinical features is of great importance for further improvement of surgical results. The aim of this retrospective study was a risk analysis concerning clinical features of the pre–, intra– and postoperative period. Between 02/1997 and 12/2003, 165 patients (130 male, 35 female, age 55.5 ± 13.8 years) were referred for surgical therapy of infective endocarditis at our institution. Preoperative, intraoperative and postoperative features were evaluated for their influence on the early postoperative course and the mid–term follow–up. In the majority of patients (pts) the aortic valve was infected (n = 83, 50.3% of pts), followed by mitral valve (n = 33; 20.0%), tricuspid valve (n = 10, 6.0%) and pulmonary valve (n = 2; 1.2%). Double valve affection was recorded in 37 pts (22.4%). Streptococci (n = 66, 40.0%) and staphylococci (n = 66, 40.0%) were the most common pathogens. The overall hospital mortality rate was 10.9% (n = 18), during follow–up (mean follow–up 3.3 ± 2.5 years) a further 20 pts (12.1%) died. Main predictors for hospital mortality in multivariate analysis were older age (p = 0.01), prolonged ICU stay, prolonged intubation (p = 0.03; p = 0.02) and the continuous postoperative need of alpha–catecholamine medication (p < 0.01). Significant predictors of overall mortality were older age (> 70 years) and diabetes (p = 0.03; p = 0.03). Reinfection occurred in 6.1% of patients (n = 10). Actuarial freedom from recurrent infection was 97% at 1 year and 93.9% at 5 years. Surgical therapy of infective endocarditis is associated with good clinical results in the early and mid–term follow–up. Predictors of outcome particular include preoperative risk constellation or comorbidity (age, diabetes) and variables of the immediate postoperative course. Alexiou, Konstantin verfasserin aut Wilbring, Manuel verfasserin aut Daubner, Dirk verfasserin aut Kappert, Utz verfasserin aut Knaut, Michael verfasserin aut Matschke, Klaus verfasserin aut Enthalten in Zeitschrift für Kardiologie Darmstadt : Steinkopff, 1997 95(2006), 2 vom: 16. Jan., Seite 72-79 (DE-627)254911137 (DE-600)1463330-9 1435-1285 nnns volume:95 year:2006 number:2 day:16 month:01 pages:72-79 https://dx.doi.org/10.1007/s00392-006-0326-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 44.67 ASE 44.85 ASE AR 95 2006 2 16 01 72-79 |
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native infective endocarditis: which determinants of outcome remain after surgical treatment? |
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Native infective endocarditis: Which determinants of outcome remain after surgical treatment? |
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Summary Surgical therapy of native infective endocarditis is still considered as a particular challenge, due to remaining morbidity and mortality up to 20%. Further risk analysis and characterization of clinical features is of great importance for further improvement of surgical results. The aim of this retrospective study was a risk analysis concerning clinical features of the pre–, intra– and postoperative period. Between 02/1997 and 12/2003, 165 patients (130 male, 35 female, age 55.5 ± 13.8 years) were referred for surgical therapy of infective endocarditis at our institution. Preoperative, intraoperative and postoperative features were evaluated for their influence on the early postoperative course and the mid–term follow–up. In the majority of patients (pts) the aortic valve was infected (n = 83, 50.3% of pts), followed by mitral valve (n = 33; 20.0%), tricuspid valve (n = 10, 6.0%) and pulmonary valve (n = 2; 1.2%). Double valve affection was recorded in 37 pts (22.4%). Streptococci (n = 66, 40.0%) and staphylococci (n = 66, 40.0%) were the most common pathogens. The overall hospital mortality rate was 10.9% (n = 18), during follow–up (mean follow–up 3.3 ± 2.5 years) a further 20 pts (12.1%) died. Main predictors for hospital mortality in multivariate analysis were older age (p = 0.01), prolonged ICU stay, prolonged intubation (p = 0.03; p = 0.02) and the continuous postoperative need of alpha–catecholamine medication (p < 0.01). Significant predictors of overall mortality were older age (> 70 years) and diabetes (p = 0.03; p = 0.03). Reinfection occurred in 6.1% of patients (n = 10). Actuarial freedom from recurrent infection was 97% at 1 year and 93.9% at 5 years. Surgical therapy of infective endocarditis is associated with good clinical results in the early and mid–term follow–up. Predictors of outcome particular include preoperative risk constellation or comorbidity (age, diabetes) and variables of the immediate postoperative course. |
| abstractGer |
Summary Surgical therapy of native infective endocarditis is still considered as a particular challenge, due to remaining morbidity and mortality up to 20%. Further risk analysis and characterization of clinical features is of great importance for further improvement of surgical results. The aim of this retrospective study was a risk analysis concerning clinical features of the pre–, intra– and postoperative period. Between 02/1997 and 12/2003, 165 patients (130 male, 35 female, age 55.5 ± 13.8 years) were referred for surgical therapy of infective endocarditis at our institution. Preoperative, intraoperative and postoperative features were evaluated for their influence on the early postoperative course and the mid–term follow–up. In the majority of patients (pts) the aortic valve was infected (n = 83, 50.3% of pts), followed by mitral valve (n = 33; 20.0%), tricuspid valve (n = 10, 6.0%) and pulmonary valve (n = 2; 1.2%). Double valve affection was recorded in 37 pts (22.4%). Streptococci (n = 66, 40.0%) and staphylococci (n = 66, 40.0%) were the most common pathogens. The overall hospital mortality rate was 10.9% (n = 18), during follow–up (mean follow–up 3.3 ± 2.5 years) a further 20 pts (12.1%) died. Main predictors for hospital mortality in multivariate analysis were older age (p = 0.01), prolonged ICU stay, prolonged intubation (p = 0.03; p = 0.02) and the continuous postoperative need of alpha–catecholamine medication (p < 0.01). Significant predictors of overall mortality were older age (> 70 years) and diabetes (p = 0.03; p = 0.03). Reinfection occurred in 6.1% of patients (n = 10). Actuarial freedom from recurrent infection was 97% at 1 year and 93.9% at 5 years. Surgical therapy of infective endocarditis is associated with good clinical results in the early and mid–term follow–up. Predictors of outcome particular include preoperative risk constellation or comorbidity (age, diabetes) and variables of the immediate postoperative course. |
| abstract_unstemmed |
Summary Surgical therapy of native infective endocarditis is still considered as a particular challenge, due to remaining morbidity and mortality up to 20%. Further risk analysis and characterization of clinical features is of great importance for further improvement of surgical results. The aim of this retrospective study was a risk analysis concerning clinical features of the pre–, intra– and postoperative period. Between 02/1997 and 12/2003, 165 patients (130 male, 35 female, age 55.5 ± 13.8 years) were referred for surgical therapy of infective endocarditis at our institution. Preoperative, intraoperative and postoperative features were evaluated for their influence on the early postoperative course and the mid–term follow–up. In the majority of patients (pts) the aortic valve was infected (n = 83, 50.3% of pts), followed by mitral valve (n = 33; 20.0%), tricuspid valve (n = 10, 6.0%) and pulmonary valve (n = 2; 1.2%). Double valve affection was recorded in 37 pts (22.4%). Streptococci (n = 66, 40.0%) and staphylococci (n = 66, 40.0%) were the most common pathogens. The overall hospital mortality rate was 10.9% (n = 18), during follow–up (mean follow–up 3.3 ± 2.5 years) a further 20 pts (12.1%) died. Main predictors for hospital mortality in multivariate analysis were older age (p = 0.01), prolonged ICU stay, prolonged intubation (p = 0.03; p = 0.02) and the continuous postoperative need of alpha–catecholamine medication (p < 0.01). Significant predictors of overall mortality were older age (> 70 years) and diabetes (p = 0.03; p = 0.03). Reinfection occurred in 6.1% of patients (n = 10). Actuarial freedom from recurrent infection was 97% at 1 year and 93.9% at 5 years. Surgical therapy of infective endocarditis is associated with good clinical results in the early and mid–term follow–up. Predictors of outcome particular include preoperative risk constellation or comorbidity (age, diabetes) and variables of the immediate postoperative course. |
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Further risk analysis and characterization of clinical features is of great importance for further improvement of surgical results. The aim of this retrospective study was a risk analysis concerning clinical features of the pre–, intra– and postoperative period. Between 02/1997 and 12/2003, 165 patients (130 male, 35 female, age 55.5 ± 13.8 years) were referred for surgical therapy of infective endocarditis at our institution. Preoperative, intraoperative and postoperative features were evaluated for their influence on the early postoperative course and the mid–term follow–up. In the majority of patients (pts) the aortic valve was infected (n = 83, 50.3% of pts), followed by mitral valve (n = 33; 20.0%), tricuspid valve (n = 10, 6.0%) and pulmonary valve (n = 2; 1.2%). Double valve affection was recorded in 37 pts (22.4%). Streptococci (n = 66, 40.0%) and staphylococci (n = 66, 40.0%) were the most common pathogens. The overall hospital mortality rate was 10.9% (n = 18), during follow–up (mean follow–up 3.3 ± 2.5 years) a further 20 pts (12.1%) died. Main predictors for hospital mortality in multivariate analysis were older age (p = 0.01), prolonged ICU stay, prolonged intubation (p = 0.03; p = 0.02) and the continuous postoperative need of alpha–catecholamine medication (p < 0.01). Significant predictors of overall mortality were older age (> 70 years) and diabetes (p = 0.03; p = 0.03). Reinfection occurred in 6.1% of patients (n = 10). Actuarial freedom from recurrent infection was 97% at 1 year and 93.9% at 5 years. Surgical therapy of infective endocarditis is associated with good clinical results in the early and mid–term follow–up. 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