Universität zu Köln

Weber, Carolyn, Luehr, Maximilian ORCID: 0000-0002-0645-1764, Petrov, Georgi, Misfeld, Martin, Akhyari, Payam, Tugtekin, Sems-Malte, Diab, Mahmoud, Saha, Shekhar, Elderia, Ahmed, Lichtenberg, Artur, Hagl, Christian, Doenst, Torsten, Matschke, Klaus, Borger, Michael A. and Wahlers, Thorsten (2022). Impact of the 2009 ESC Guideline Change on Surgically Treated Infective Endocarditis. Ann. Thorac. Surg., 114 (4). S. 1349 - 1357. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1552-6259

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Abstract

BACKGROUND In 2009, updated European Society of Cardiology guidelines on the prevention, diagnosis, and treat-ment of infective endocarditis (IE) were released and restricted the use of antibiotic prophylaxis to high-risk patients only. The aim of this study was to analyze the effect of the restrictive antibiotic regimen on the incidence and mani-festations of surgically treated IE before and after the guideline change.METHODS This study retrospectively analyzed data of 4917 patients who underwent valve surgical procedures for IE between 1994 and 2018 in 6 German cardiac surgery centers. Potential risk factors for 30-day mortality were assessed using logistic regression. Interrupted time series regression was used to evaluate the effect of the guideline change on the manifestation of IE.RESULTS A total of 2014 patients (41%) underwent surgical procedures before the guideline change, and 2903 patients (59%) underwent surgical procedures after the change. After 2009, patients were older (67.0 years [interquartile range, 56.0-74.0 years] vs 64.0 years [interquartile range, 52.0-71.0 years]; P < .001), and they presented with more comorbidities, such as hypertension (56.9% vs 41.7%; P < .001), diabetes (27.4% vs 24.4%; P = .020), peripheral artery disease (8.5% vs 6.5%; P = .011), and preoperative acute kidney injury (42.8% vs 31.9%; P< .001). Patients had worse clinical outcomes with respect to 30-day mortality (18.1% vs 14.3%; P = .001) and 1-year mortality (37.1% vs 29.1%; P < .001). An increase in Streptococcus-related IE (P = .002) and an increase in mitral valve IE (P = .035) were observed after the guideline change.CONCLUSIONS Since 2009, there has been a significant increase in the incidence of mitral valve IE and Streptococcus -related IE. Patients undergoing surgical procedures for IE present with more comorbidities, which contribute to high mortality rates.(Ann Thorac Surg 2022;114:1349-57)(c) 2022 by The Society of Thoracic Surgeons

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Luehr, Maximilian UNSPECIFIED orcid.org/0000-0002-0645-1764 UNSPECIFIED Petrov, Georgi UNSPECIFIED UNSPECIFIED UNSPECIFIED Misfeld, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Akhyari, Payam UNSPECIFIED UNSPECIFIED UNSPECIFIED Tugtekin, Sems-Malte UNSPECIFIED UNSPECIFIED UNSPECIFIED Diab, Mahmoud UNSPECIFIED UNSPECIFIED UNSPECIFIED Saha, Shekhar UNSPECIFIED UNSPECIFIED UNSPECIFIED Elderia, Ahmed UNSPECIFIED UNSPECIFIED UNSPECIFIED Lichtenberg, Artur UNSPECIFIED UNSPECIFIED UNSPECIFIED Hagl, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Doenst, Torsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Matschke, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Borger, Michael A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-690042
DOI:	10.1016/j.athoracsur.2022.01.054
Journal or Publication Title:	Ann. Thorac. Surg.
Volume:	114
Number:	4
Page Range:	S. 1349 - 1357
Date:	2022
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 VIRIDANS GROUP STREPTOCOCCI; TEMPORAL TRENDS; PROPHYLAXIS; PREVENTION; HOSPITALIZATIONS; POPULATION; DIAGNOSIS Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69004