Surgical treatment for infective endocarditis and hospital mortality in a Brazilian single-center
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| Natura: | Artículo científico |
| Lingua: | en |
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Sociedade Brasileira de Cirurgia Cardiovascular
2013
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| _version_ | 1876469126804799488 |
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| author | Maurício Nassau Machado |
| author_facet | Maurício Nassau Machado |
| contents | Surgical treatment for infective endocarditis and hospital mortality in a Brazilian single-center Maurício Nassau Machado Marcelo Arruda Nakazone Jamil Ali Murad-Júnior Lilia Nigro Maia Medicina Hospital mortality Bacterial endocarditis Cardiac surgical procedures OBJECTIVE: We evaluated patients underwent cardiac valve surgery in the presence of infective endocarditis in an attempt to identify independent predictors of 30-day mortality.METHODS: We evaluated 837 consecutive patients underwent cardiac valve surgery from January 2003 to May 2010 in a tertiary hospital in São José do Rio Preto, São Paulo (SP), Brazil. The study group comprised patients who underwent intervention in the presence of infective endocarditis and was compared to the control group (without infective endocarditis), evaluating perioperative clinical outcomes and 30-day all cause mortality.RESULTS: In our series, 64 patients (8%) underwent cardiac valve surgery in the presence of infective endocarditis, and 37.5% of them had surgical intervention in multiple valves. The study group had prolonged ICU length of stay (16%), greater need for dialysis (9%) and higher 30-day mortality (17%) compared to the control group (7%, P=0.020; 2%, P=0.002 and 9%, P=0.038; respectively). In a Cox regression analysis, age (P = 0.007), acute kidney injury (P = 0.004), dialysis (P = 0.026), redo surgery (P = 0.026), re-exploration for bleeding (P = 0.013), tracheal reintubation (P <0.001) and type I neurological injury (P <0.001) were identified as independent predictors for death. Although the manifestation of infective endocarditis influenced on mortality in univariate analysis, multivariate Cox regression analysis did not confirm such variable as an independent predictor of death.CONCLUSION: Age and perioperative complications stand out as predictors of hospital mortality in Brazilian population. Cardiac valve surgery in the presence of active infective endocarditis was not confirmed itself as an independent predictor of 30-day mortality. 2013 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398941888006 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.1 Vol.28 |
| format | Artículo científico |
| id | redalyc_398941888006 |
| institution | Redalyc |
| language | en |
| publishDate | 2013 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| spellingShingle | Surgical treatment for infective endocarditis and hospital mortality in a Brazilian single-center Maurício Nassau Machado Medicina Hospital mortality Bacterial endocarditis Cardiac surgical procedures Surgical treatment for infective endocarditis and hospital mortality in a Brazilian single-center Maurício Nassau Machado Marcelo Arruda Nakazone Jamil Ali Murad-Júnior Lilia Nigro Maia Medicina Hospital mortality Bacterial endocarditis Cardiac surgical procedures OBJECTIVE: We evaluated patients underwent cardiac valve surgery in the presence of infective endocarditis in an attempt to identify independent predictors of 30-day mortality.METHODS: We evaluated 837 consecutive patients underwent cardiac valve surgery from January 2003 to May 2010 in a tertiary hospital in São José do Rio Preto, São Paulo (SP), Brazil. The study group comprised patients who underwent intervention in the presence of infective endocarditis and was compared to the control group (without infective endocarditis), evaluating perioperative clinical outcomes and 30-day all cause mortality.RESULTS: In our series, 64 patients (8%) underwent cardiac valve surgery in the presence of infective endocarditis, and 37.5% of them had surgical intervention in multiple valves. The study group had prolonged ICU length of stay (16%), greater need for dialysis (9%) and higher 30-day mortality (17%) compared to the control group (7%, P=0.020; 2%, P=0.002 and 9%, P=0.038; respectively). In a Cox regression analysis, age (P = 0.007), acute kidney injury (P = 0.004), dialysis (P = 0.026), redo surgery (P = 0.026), re-exploration for bleeding (P = 0.013), tracheal reintubation (P <0.001) and type I neurological injury (P <0.001) were identified as independent predictors for death. Although the manifestation of infective endocarditis influenced on mortality in univariate analysis, multivariate Cox regression analysis did not confirm such variable as an independent predictor of death.CONCLUSION: Age and perioperative complications stand out as predictors of hospital mortality in Brazilian population. Cardiac valve surgery in the presence of active infective endocarditis was not confirmed itself as an independent predictor of 30-day mortality. 2013 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398941888006 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.1 Vol.28 |
| title | Surgical treatment for infective endocarditis and hospital mortality in a Brazilian single-center |
| topic | Medicina Hospital mortality Bacterial endocarditis Cardiac surgical procedures |
| url | https://www.redalyc.org/articulo.oa?id=398941888006 |