Universität zu Köln

Weber, Carolyn, Gassa, Asmae, Rokohl, Alexander ORCID: 0000-0002-0224-3597, Sabashnikov, Anton, Deppe, Antje-Christin, Eghbalzadeh, Kaveh, Merkle, Julia, Hamacher, Stefanie ORCID: 0000-0003-2158-9101, Liakopoulos, Oliver J. and Wahlers, Thorsten (2019). Severity of Presentation, Not Sex, Increases Risk of Surgery for Infective Endocarditis. Ann. Thorac. Surg., 107 (4). S. 1111 - 1120. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1552-6259

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Abstract

Background. Cardiac surgery for infective endocarditis (IE) is associated with substantial short- and long-term mortality, and female sex seems to be associated with even worse outcomes. The aim of our study was to analyze the impact of sex on 30-day and long-term mortality and to identify sex-related risk factors in IE patients requiring cardiac surgery. Methods. Relevant clinical data of all consecutive 305 patients undergoing cardiac surgery for IE between 2009 and 2016 were extracted from our institutional database and retrospectively analyzed. Infective endocarditis was defined according to the recent modified Duke criteria and surgery indicated in compliance with current European Society of Cardiology guidelines. Sex-related postoperative outcomes including 30-day and 1-year mortality were recorded. Univariate and multivariable analysis was performed to identify potential sex-dependent risk factors. Results. In all, 229 male patients (75.1%) and 76 female patients (24.9%) underwent surgery for IE. Female patients showed significantly more mitral valve infection (52.6% versus 33.6%, p = 0.003), and Staphylococcus aureus as causative microorganisms was diagnosed in 44.7% of female patients compared with 24.5% of male patients (p = 0.001). Female sex was associated with a higher 30-day mortality (18.4% versus 8.3%, p = 0.014) and 1-year mortality (46.1% versus 27.1%, p = 0.002). Multivariable analysis revealed not female sex, but European System for Cardiac Operative Risk Evaluation II score, reexploration for bleeding, and postoperative acute kidney injury as independent risk factors for 30-day mortality and preoperative dialysis for 1-year mortality, respectively. Conclusions. In this study, female sex was associated with more severe manifestations of IE and significantly higher 30-day and 1-year mortality. After multivariable analysis, not female sex, but the underlying comorbidities seem to determine clinical outcomes. (C) 2019 by The Society of Thoracic Surgeons

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Gassa, Asmae UNSPECIFIED UNSPECIFIED UNSPECIFIED Rokohl, Alexander UNSPECIFIED orcid.org/0000-0002-0224-3597 UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Deppe, Antje-Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Eghbalzadeh, Kaveh UNSPECIFIED UNSPECIFIED UNSPECIFIED Merkle, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamacher, Stefanie UNSPECIFIED orcid.org/0000-0003-2158-9101 UNSPECIFIED Liakopoulos, Oliver J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-152578
DOI:	10.1016/j.athoracsur.2018.10.033
Journal or Publication Title:	Ann. Thorac. Surg.
Volume:	107
Number:	4
Page Range:	S. 1111 - 1120
Date:	2019
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1552-6259
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GENDER-RELATED DIFFERENCES; CARDIAC-SURGERY; COMBINED VALVE; MORTALITY; MANAGEMENT; MORBIDITY; IMPACT; POPULATION; OPERATION; OUTCOMES Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15257