Universität zu Köln

Farag, Mina, Borst, Tobias, Sabashnikov, Anton, Zeriouh, Mohamed, Schmack, Bastian, Arif, Rawa, Beller, Carsten J., Popov, Aron-Frederik ORCID: 0000-0003-4226-3004, Kallenbach, Klaus, Ruhparwar, Arjang, Dohmen, Pascal M., Szabo, Gabor, Karck, Matthias and Weymann, Alexander (2017). Surgery for Infective Endocarditis: Outcomes and Predictors of Mortality in 360 Consecutive Patients. Med. Sci. Monitor, 23. S. 3617 - 3627. MELVILLE: INT SCIENTIFIC INFORMATION, INC. ISSN 1643-3750

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Abstract

Background: A retrospective analysis was conducted of the early and long-term outcomes after surgery for infective endocarditis (IE). Material/Methods: We included 360 patients with IE operated upon between 1993 and 2012. The primary endpoint was overall cumulative postoperative survival at 30 days. Secondary endpoints were early postoperative outcomes and complication rates. Factors associated with 30-day mortality were analyzed. Results: Mean age was 58.7 +/- 14.7 years and 26.9% (n=97) were female. The mean follow-up was 4.41 +/- 4.53 years. Postoperative survival was 81.7% at 30 days, 69.4% at 1 year, 63.3% at 5 years, and 63.3% at 10 years. Nonsurvivors were significantly older (p=0.014), with higher NYHA Class (p=0.002), had higher rates of preoperative diabetes mellitus (p=0.005), renal failure (p=0.001), and hepatic disease (p=0.002). Furthermore, non-survivors had higher baseline alanine aminotransferase (ALT, p=0.048), aspartate transaminase (AST, p=0.027), bilirubin (p=0.013), white cell count (WCC, p=0.034), and CRP (p=0.049). Factors associated with 30-day mortality were longer duration of surgery, CPB, and aortic cross-clamping times (p<0.001, p<0.001, and p=0.003, respectively), as well as higher RBC, FFP, and platelet transfusion requirements (p<0.001, p=0.005, and p<0.001, respectively). Multivariate logistic regression analysis revealed liver cirrhosis (OR 4.583, 95-CI: 1.096-19.170, p=0.037) and longer CPB time (OR 1.025, 95-CI 1.008-1.042, p=0.004) as independent predictors of 30-day mortality. Conclusions: Surgical treatment of IE shows satisfactory early, midterm, and long-term results. Multivariate logistic regression analysis revealed cirrhosis and longer CPB time as independent predictors of 30-day mortality.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Farag, Mina UNSPECIFIED UNSPECIFIED UNSPECIFIED Borst, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeriouh, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmack, Bastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Arif, Rawa UNSPECIFIED UNSPECIFIED UNSPECIFIED Beller, Carsten J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Popov, Aron-Frederik UNSPECIFIED orcid.org/0000-0003-4226-3004 UNSPECIFIED Kallenbach, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruhparwar, Arjang UNSPECIFIED UNSPECIFIED UNSPECIFIED Dohmen, Pascal M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Szabo, Gabor UNSPECIFIED UNSPECIFIED UNSPECIFIED Karck, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Weymann, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-224726
DOI:	10.12659/MSM.902340
Journal or Publication Title:	Med. Sci. Monitor
Volume:	23
Page Range:	S. 3617 - 3627
Date:	2017
Publisher:	INT SCIENTIFIC INFORMATION, INC
Place of Publication:	MELVILLE
ISSN:	1643-3750
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MITRAL-VALVE ENDOCARDITIS; SURGICAL-MANAGEMENT; STAPHYLOCOCCUS-AUREUS; CLINICAL PRESENTATION; MEDICAL PROGRESS; RISK; DIAGNOSIS; PROFILE; COMPLICATIONS; REPLACEMENT Multiple languages Medicine, Research & Experimental Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22472