Influence of the timing of cardiac surgery on the outcome of patients with infective endocarditis and stroke.
Détails
ID Serval
serval:BIB_74EF3F5152EF
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Influence of the timing of cardiac surgery on the outcome of patients with infective endocarditis and stroke.
Périodique
Clinical Infectious Diseases
Collaborateur⸱rice⸱s
International Collaboration on Endocarditis-Prospective Cohort Study Investigators
Contributeur⸱rice⸱s
Clara L., Sanchez M., Nacinovich F., Fernandez P., Ronderos R., Sucari A., Thierer J., Casabé J., Cortes C., Altclas J., Kogan S., Spelman D., Athan E., Harris O., Kennedy K., Tan R., Gordon D., Papanicolas L., Eisen D., Grigg L., Street A., Korman T., Kotsanas D., Dever R., Jones P., Konecny P., Lawrence R., Rees D., Ryan S., Feneley MP., Harkness J., Jones P., Ryan S., Jones P., Ryan S., Jones P., Post J., Reinbott P., Ryan S., Gattringer R., Wiesbauer F., Andrade AR., de Brito£££Ana Cláudia Passos£££ AC. , Guimarães AC., Grinberg M., Mansur AJ., Siciliano RF., Strabelli TM., Vieira ML., de Medeiros Tranchesi RA. , Paiva MG., Fortes CQ., Ramos Ade O., Ferraiuoli G., Golebiovski W., Lamas C., Santos M., Weksler C., Karlowsky JA., Keynan Y., Morris AM., Rubinstein E., Jones SB., Garcia P., Cereceda M., Fica A., Mella RM., Barsic B., Bukovski S., Krajinovic V., Pangercic A., Rudez I., Vincelj J., Freiberger T., Pol J., Zaloudikova B., Ashour Z., El Kholy A., Mishaal M., Rizk H., Aissa N., Alauzet C., Alla F., Campagnac C., Doco-Lecompte T., Selton-Suty C., Casalta JP., Fournier PE., Habib G., Raoult D., Thuny F., Delahaye F., Delahaye A., Vandenesch F., Donal E., Donnio PY., Michelet C., Revest M., Tattevin P., Violette J., Chevalier F., Jeu A., Rusinaru D., Sorel C., Tribouilloy C., Bernard Y., Chirouze C., Hoen B., Leroy J., Plesiat P., Naber GC., Neuerburg C., Mazaheri B., Naber C., Neuerburg C., Athanasia S., Giannitsioti E., Mylona E., Paniara O., Papanicolaou K., Pyros J., Skoutelis A., Sharma G., Francis J., Nair L., Thomas DM., Venugopal K., Hannan M., Hurley J., Cahan A., Gilon D., Israel S., Strahilevitz J., Rubinstein E., Strahilevitz J., Tripodi MF., Casillo R., Cuccurullo S., Dialetto G., Durante-Mangoni E., Irene M., Ragone E., Utili R., Cecchi E., De Rosa F., Forno D., Imazio M., Trinchero R., Tebini A., Grossi P., Lattanzio M., Toniolo A., Goglio A., Raglio A., Ravasio V., Rizzi M., Suter F., Carosi G., Magri S., Signorini L., Baban T., Kanafani Z., Kanj SS., Sfeir J., Yasmine M., Abidin I., Tamin SS., Martínez ER., Nieto GI., van der Meer JT. , Chambers S., Murdoch DR., Holland D., Morris A., Raymond N., Read K., Dragulescu S., Ionac A., Mornos C., Butkevich OM., Chipigina N., Kirill O., Vadim K., Vinogradova T., Edathodu J., Halim M., Lum LN., Tan RS., Lejko-Zupanc T., Logar M., Mueller-Premru M., Commerford P., Commerford A., Deetlefs E., Hansa C., Ntsekhe M., Almela M., Armero Y., Azqueta M., Castañeda X., Cervera C., del Rio A., Falces C., Garcia-de-la-Maria C., Fita G., Gatell JM., Marco F., Mestres CA., Miró JM., Moreno A., Ninot S., Paré C., Pericas J., Ramirez J., Rovira I., Sitges M., Anguera I., Guma JR., Bermejo J., Bouza E., Fernández MA., Gonzalez-Ramallo V., Marín M., Muñoz P., Pedromingo M., Roda J., Rodríguez-Créixems M., Solis J., Almirante B., Fernandez-Hidalgo N., Tornos P., de Alarcón£££Arístides£££ A. , Parra R., Alestig E., Johansson M., Olaison L., Snygg-Martin U., Pachirat O., Pachirat P., Pussadhamma B., Senthong V., Casey A., Elliott T., Lambert P., Watkin R., Eyton C., Klein JL., Bradley S., Kauffman C., Bedimo R., Chu VH., Corey G., Crowley AL., Douglas P., Drew L., Fowler VG., Holland T., Lalani T., Mudrick D., Samad Z., Sexton D., Stryjewski M., Wang A., Woods CW., Lerakis S., Cantey R., Steed L., Wray D., Dickerman SA., Bonilla H., DiPersio J., Salstrom SJ., Baddley J., Patel M., Peterson G., Stancoven A., Afonso L., Kulman T., Levine D., Rybak M., Baloch CH., Chu VH., Corey GR., Dixon CC., Fowler VG.<Suffix>Jr</Suffix> , Harding T., Jones-Richmond M., Pappas P., Park LP., Redick T., Stafford J., Anstrom K., Athan E., Bayer AS., Cabell CH., Chu VH., Corey GR., Fowler VG.<Suffix>Jr</Suffix> , Hoen B., Karchmer AW., Miró JM., Murdoch DR., Sexton DJ., Wang A., Bayer AS., Cabell CH., Chu V., Corey GR., Durack DT., Eykyn S., Fowler VG.<Suffix>Jr</Suffix> , Hoen B., Miró JM., Moreillon P., Olaison L., Raoult D., Rubinstein E., Sexton DJ.
ISSN
1537-6591 (Electronic)
ISSN-L
1058-4838
Statut éditorial
Publié
Date de publication
2013
Volume
56
Numéro
2
Pages
209-217
Langue
anglais
Résumé
BACKGROUND: The timing of cardiac surgery after stroke in infective endocarditis (IE) remains controversial. We examined the relationship between the timing of surgery after stroke and the incidence of in-hospital and 1-year mortalities.
METHODS: Data were obtained from the International Collaboration on Endocarditis-Prospective Cohort Study of 4794 patients with definite IE who were admitted to 64 centers from June 2000 through December 2006. Multivariate logistic regression and Cox regression analyses were performed to estimate the impact of early surgery on hospital and 1-year mortality after adjustments for other significant covariates.
RESULTS: Of the 857 patients with IE complicated by ischemic stroke syndromes, 198 who underwent valve replacement surgery poststroke were available for analysis. Overall, 58 (29.3%) patients underwent early surgical treatment vs 140 (70.7%) patients who underwent late surgical treatment. After adjustment for other risk factors, early surgery was not significantly associated with increased in-hospital mortality rates (odds ratio, 2.308; 95% confidence interval [CI], .942-5.652). Overall, probability of death after 1-year follow-up did not differ between 2 treatment groups (27.1% in early surgery and 19.2% in late surgery group, P = .328; adjusted hazard ratio, 1.138; 95% CI, .802-1.650).
CONCLUSIONS: There is no apparent survival benefit in delaying surgery when indicated in IE patients after ischemic stroke. Further observational analyses that include detailed pre- and postoperative clinical neurologic findings and advanced imaging data (eg, ischemic stroke size), may allow for more refined recommendations on the optimal timing of valvular surgery in patients with IE and recent stroke syndromes.
METHODS: Data were obtained from the International Collaboration on Endocarditis-Prospective Cohort Study of 4794 patients with definite IE who were admitted to 64 centers from June 2000 through December 2006. Multivariate logistic regression and Cox regression analyses were performed to estimate the impact of early surgery on hospital and 1-year mortality after adjustments for other significant covariates.
RESULTS: Of the 857 patients with IE complicated by ischemic stroke syndromes, 198 who underwent valve replacement surgery poststroke were available for analysis. Overall, 58 (29.3%) patients underwent early surgical treatment vs 140 (70.7%) patients who underwent late surgical treatment. After adjustment for other risk factors, early surgery was not significantly associated with increased in-hospital mortality rates (odds ratio, 2.308; 95% confidence interval [CI], .942-5.652). Overall, probability of death after 1-year follow-up did not differ between 2 treatment groups (27.1% in early surgery and 19.2% in late surgery group, P = .328; adjusted hazard ratio, 1.138; 95% CI, .802-1.650).
CONCLUSIONS: There is no apparent survival benefit in delaying surgery when indicated in IE patients after ischemic stroke. Further observational analyses that include detailed pre- and postoperative clinical neurologic findings and advanced imaging data (eg, ischemic stroke size), may allow for more refined recommendations on the optimal timing of valvular surgery in patients with IE and recent stroke syndromes.
Mots-clé
Adult, Aged, Cardiac Surgical Procedures/adverse effects, Cohort Studies, Endocarditis/mortality, Female, Hospital Mortality, Humans, Inpatients, Male, Middle Aged, Stroke/mortality, Time Factors
Pubmed
Web of science
Création de la notice
29/01/2014 11:02
Dernière modification de la notice
20/08/2019 14:32
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