In-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis.
Détails
ID Serval
serval:BIB_FC667FBDEF40
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
In-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis.
Périodique
JAMA Internal Medicine
Collaborateur⸱rice⸱s
International Collaboration on Endocarditis-Prospective Cohort Study Investigators
Contributeur⸱rice⸱s
Clara L., Sanchez M., Casabé J., Cortes C., Nacinovich F., Oses PF., Ronderos R., Sucari A., Thierer J., 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., Tranchesi RA., Paiva MG., Fortes CQ., Ramos Ade O., Ferraiuoli G., Golebiovski W., Lamas C., Weksler C., Santos M., Karlowsky JA., Keynan Y., Morris AM., Rubinstein E., Jones SB., Garcia P., Cereceda M., Fica A., Mella RM., Fernandez R., Franco L., Gonzalez J., Jaramillo AN., 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., Osama D., 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., Flecher E., Michelet C., Revest M., Tattevin P., Chevalier F., Jeu A., Rémadi JP., Rusinaru D., Tribouilloy C., Bernard Y., Chirouze C., Hoen B., Leroy J., Plesiat P., Naber C., Neuerburg C., Mazaheri B., Naber C., Neuerburg C., Thomas T., Giannitsioti E., Mylona E., Paniara O., Papanikolaou K., Pyros J., Skoutelis A., Sharma G., Francis J., Nair L., Thomas V., Venugopal K., Hannan M., Hurley J., Cahan A., Gilon D., Israel S., Korem M., Strahilevitz J., Rubinstein E., Strahilevitz J., Durante-Mangoni E., Mattucci I., Pinto D., Agrusta F., Senese A., 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., Anouti K., Chahoud J., Kanafani Z., Kanj SS., Abidin I., Tamin SS., Martínez ER., Nieto GI., van der Meer JT. , Chambers S., Holland D., Morris A., Raymond N., Read K., Murdoch DR., Dragulescu S., Ionac A., Mornos C., Butkevich O., Chipigina N., Kirill O., Vadim K., Vinogradova T., Edathodu J., Halim M., Liew YY., 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., Heras M., Llopis J., Marco F., Mestres CA., Miró JM., Moreno A., Ninot S., Paré C., Pericas JM., Ramirez J., Rovira I., Sitges M., Anguera I., Font B., 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., Levine D., Riddle J., Rybak M., Cabell CH., Baloch K., Chu VH., Corey G., Dixon CC., Fowler VG.<Suffix>Jr</Suffix> , Harding T., Jones-Richmond M., Pappas P., Park LP., Sanderford B., Stafford J., Anstrom K., Athan E., Bayer AS., Cabell CH., Chu VH., Corey G., Fowler VG.<Suffix>Jr</Suffix> , Hoen B., Karchmer A., Miró JM., Murdoch DR., Sexton DJ., Wang A., Bayer AS., Cabell CH., Chu V., Corey G., Durack DT., Eykyn S., Fowler VG.<Suffix>Jr</Suffix> , Hoen B., Miró JM., Moreillon P., Olaison L., Raoult D., Rubinstein E., Sexton DJ.
ISSN
2168-6114 (Electronic)
ISSN-L
2168-6106
Statut éditorial
Publié
Date de publication
2013
Volume
173
Numéro
16
Pages
1495-1504
Langue
anglais
Résumé
IMPORTANCE: There are limited prospective, controlled data evaluating survival in patients receiving early surgery vs medical therapy for prosthetic valve endocarditis (PVE).
OBJECTIVE: To determine the in-hospital and 1-year mortality in patients with PVE who undergo valve replacement during index hospitalization compared with patients who receive medical therapy alone, after controlling for survival and treatment selection bias.
DESIGN, SETTING, AND PARTICIPANTS: Participants were enrolled between June 2000 and December 2006 in the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), a prospective, multinational, observational cohort of patients with infective endocarditis. Patients hospitalized with definite right- or left-sided PVE were included in the analysis. We evaluated the effect of treatment assignment on mortality, after adjusting for biases using a Cox proportional hazards model that included inverse probability of treatment weighting and surgery as a time-dependent covariate. The cohort was stratified by probability (propensity) for surgery, and outcomes were compared between the treatment groups within each stratum.
INTERVENTIONS: Valve replacement during index hospitalization (early surgery) vs medical therapy.
MAIN OUTCOMES AND MEASURES: In-hospital and 1-year mortality.
RESULTS: Of the 1025 patients with PVE, 490 patients (47.8%) underwent early surgery and 535 individuals (52.2%) received medical therapy alone. Compared with medical therapy, early surgery was associated with lower in-hospital mortality in the unadjusted analysis and after controlling for treatment selection bias (in-hospital mortality: hazard ratio [HR], 0.44 [95% CI, 0.38-0.52] and lower 1-year mortality: HR, 0.57 [95% CI, 0.49-0.67]). The lower mortality associated with surgery did not persist after adjustment for survivor bias (in-hospital mortality: HR, 0.90 [95% CI, 0.76-1.07] and 1-year mortality: HR, 1.04 [95% CI, 0.89-1.23]). Subgroup analysis indicated a lower in-hospital mortality with early surgery in the highest surgical propensity quintile (21.2% vs 37.5%; P = .03). At 1-year follow-up, the reduced mortality with surgery was observed in the fourth (24.8% vs 42.9%; P = .007) and fifth (27.9% vs 50.0%; P = .007) quintiles of surgical propensity.
CONCLUSIONS AND RELEVANCE: Prosthetic valve endocarditis remains associated with a high 1-year mortality rate. After adjustment for differences in clinical characteristics and survival bias, early valve replacement was not associated with lower mortality compared with medical therapy in the overall cohort. Further studies are needed to define the effect and timing of surgery in patients with PVE who have indications for surgery.
OBJECTIVE: To determine the in-hospital and 1-year mortality in patients with PVE who undergo valve replacement during index hospitalization compared with patients who receive medical therapy alone, after controlling for survival and treatment selection bias.
DESIGN, SETTING, AND PARTICIPANTS: Participants were enrolled between June 2000 and December 2006 in the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), a prospective, multinational, observational cohort of patients with infective endocarditis. Patients hospitalized with definite right- or left-sided PVE were included in the analysis. We evaluated the effect of treatment assignment on mortality, after adjusting for biases using a Cox proportional hazards model that included inverse probability of treatment weighting and surgery as a time-dependent covariate. The cohort was stratified by probability (propensity) for surgery, and outcomes were compared between the treatment groups within each stratum.
INTERVENTIONS: Valve replacement during index hospitalization (early surgery) vs medical therapy.
MAIN OUTCOMES AND MEASURES: In-hospital and 1-year mortality.
RESULTS: Of the 1025 patients with PVE, 490 patients (47.8%) underwent early surgery and 535 individuals (52.2%) received medical therapy alone. Compared with medical therapy, early surgery was associated with lower in-hospital mortality in the unadjusted analysis and after controlling for treatment selection bias (in-hospital mortality: hazard ratio [HR], 0.44 [95% CI, 0.38-0.52] and lower 1-year mortality: HR, 0.57 [95% CI, 0.49-0.67]). The lower mortality associated with surgery did not persist after adjustment for survivor bias (in-hospital mortality: HR, 0.90 [95% CI, 0.76-1.07] and 1-year mortality: HR, 1.04 [95% CI, 0.89-1.23]). Subgroup analysis indicated a lower in-hospital mortality with early surgery in the highest surgical propensity quintile (21.2% vs 37.5%; P = .03). At 1-year follow-up, the reduced mortality with surgery was observed in the fourth (24.8% vs 42.9%; P = .007) and fifth (27.9% vs 50.0%; P = .007) quintiles of surgical propensity.
CONCLUSIONS AND RELEVANCE: Prosthetic valve endocarditis remains associated with a high 1-year mortality rate. After adjustment for differences in clinical characteristics and survival bias, early valve replacement was not associated with lower mortality compared with medical therapy in the overall cohort. Further studies are needed to define the effect and timing of surgery in patients with PVE who have indications for surgery.
Mots-clé
Aortic Valve/surgery, Endocarditis, Bacterial/mortality, Endocarditis, Bacterial/therapy, Female, Follow-Up Studies, Heart Valve Prosthesis/adverse effects, Heart Valve Prosthesis Implantation, Hospital Mortality, Humans, Male, Middle Aged, Mitral Valve/surgery, Propensity Score, Proportional Hazards Models, Prospective Studies, Prosthesis-Related Infections/mortality, Prosthesis-Related Infections/therapy, Registries, Time-to-Treatment
Pubmed
Web of science
Open Access
Oui
Création de la notice
29/01/2014 11:59
Dernière modification de la notice
20/08/2019 17:27
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