Mortality and timing of surgery in the left-sided infective endocarditis: an Italian multicentre study

Cecchi, Enrico; Ciccone, Giovannino; Chirillo, Fabio; Imazio, Massimo; Cecconi, Moreno; Ponte, Stefano del; Moreo, Antonella; Faggiano, Pompilio; Cialfi, Alessandro; Squeri, Angelo; Enia, Francesco; Forno, Davide; Rosa, Francesco Giuseppe De; Rinaldi, Mauro; Castiglione, Anna

doi:10.1093/icvts/ivx394

Cited by 10 publications

(11 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The main IE agent was S. aureus (21.9%), followed by viridans streptococci (17.7%), enterococci (13.3%), bovis -group streptococci (11.0%) and coagulase-negative staphylococci (10.9%). Similar distributions of causative microorganisms were reported in other Italian studies [32] , [33] , [34] , [36] , [37] . Other characteristics of IE in Italy include an elevated ratio of healthcare-associated cases (12.4–64.6% of cases) and a low rate of zoonotic and arthropod-borne microorganisms, notably C. burnetii and Bartonella spp.…”

Section: Resultssupporting

confidence: 88%

“…In Italy, the incidence rate of IE is 4.6/100 000 person-years, with a higher rate in people older than 65 years (11.7/100 000 person-years) [32] . Several studies demonstrated temporal changes in IE epidemiology, similar to those observed in other European countries [32] , [33] , [34] , [35] , [36] , [37] : an increase in patient age (57 to 69 years old, depending on the series), rate of prosthetic heart valve and comorbidity factors such as diabetes mellitus, chronic renal failure and cancer [33] . In the largest series, Leone et al .…”

Section: Resultssupporting

confidence: 64%

See 1 more Smart Citation

Endocarditis in the Mediterranean Basin

Gouriet¹,

Chaudet

Pellegrin

et al. 2018

New Microbes and New Infections

View full text Add to dashboard Cite

Infective endocarditis is a severe disease with high mortality. Despite a global trend towards an increase in staphylococcal aetiologies, in older patients and a decrease in viridans streptococci, we have observed in recent studies great epidemiologic disparities between countries. In order to evaluate these differences among Mediterranean countries, we performed a PubMed search of infective endocarditis case series for each country. Data were available for 13 of the 18 Mediterranean countries. Despite great differences in diagnostic strategies, we could classify countries into three groups. In northern countries, patients are older (>50 years old), have a high rate of prosthetic valves or cardiac electronic implantable devices and the main causative agent is Staphylococcus aureus. In southern countries, patients are younger (<40 years old), rheumatic heart disease remains a major risk factor (45–93%), viridans streptococci are the main pathogens, zoonotic and arthropod-borne agents are frequent and blood culture–negative endocarditis remains highly prevalent. Eastern Mediterranean countries exhibit an intermediate situation: patients are 45 to 60 years old, the incidence of rheumatic heart disease ranges from 8% to 66%, viridans streptococci play a predominant role and zoonotic and arthropod-borne diseases, in particular brucellosis, are identified in up to 12% of cases.

show abstract

Section: Resultssupporting

confidence: 88%

Section: Resultssupporting

confidence: 64%

Endocarditis in the Mediterranean Basin

Gouriet¹,

Chaudet

Pellegrin

et al. 2018

New Microbes and New Infections

View full text Add to dashboard Cite

show abstract

“…In our study, we found that the mean age at the time of IE episodes were younger than those reported from developed countries, although the mean age increased during this period. The proportion of old patients with IE increased gradually in our study period, and this shown the same trend as the developed countries [7,9].Erichsen et al [10] found that the incidence increased substantially for elderly patients between 1994 and 2011, with the highest incidence rate of 3.38 for patients more than 80 years old at IE onset. In Oliver et al' s report [11], 49% of IE patients were over 65 years old and 11.2% were over 80 years old.…”

Section: Discussionsupporting

confidence: 80%

Epidemiology and risk factors of infective endocarditis in a tertiary hospital in China from 2007 to 2016

Chen

Xiao

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: To explore the trends in epidemiology and risk factors related to the prognosis of infective endocarditis in a teaching hospital over the past ten years. Methods: A retrospective cohort study was performed. A total of 407 consecutive patients were included. The clinical characteristics and risk factors related to the prognosis of infective endocarditis during this period were analyzed. Results: A total of 407 patients with infective endocarditis were included, the average age was 48 ±16 years old with an increasing trend and in-hospital mortality rate was 10.6% and one-year mortality rate was 12.2%. Among patients with underlying heart disease, congenital heart disease was the most common(25.8%), followed by rheumatic heart disease which showed a decreased trend during this period (P<0.001). There were 222(54.5%) positive blood cultures and streptococci (44.1%) was the main pathogens with an increasing trend. There were 403 patients (99%) with surgical indications, but only 234 patients (57.5%) received surgical treatment. Hemodialysis (P = 0.041, OR = 4.697, 95% CI 1.068-20.665), pulmonary hypertension (P = 0.001, OR = 5.308, 95% CI 2.034-13.852), Pitt score ≥ 4 (P <0.001, OR = 28.5, 95% CI 5.5-148.1) and vegetation length＞30mm (P = 0.011, OR = 13.754, 95% CI 1.832-103.250) were independent risk factors for in-hospital mortality. Conclusions: There was no significant change in the overall incidence of IE, the clinical features of IE have changed slightly during the past ten years. Streptococci IE was still the predominant. IE patients with hemodialysis, pulmonary hypertension, Pitt score ≥ 4 and vegetation length＞30mm had an worse in-hospital outcome.

show abstract

“…In a recent meta‐analysis, patients operated for left‐sided endocarditis within 7 days after diagnosis had better survival in comparison to patients operated later or managed medically . However, in some retrospective studies, the benefit of ES has been questioned . In our study, even though patients operated within 7 days of prior directed antimicrobial treatment had a higher frequency of acute heart failure and emergency surgery, their 30‐day and late mortality were compared with patients operated later.…”

Section: Discussionsupporting

confidence: 61%

“…12 However, in some retrospective studies, the benefit of ES has been questioned. 13,14 In our study, even though patients operated within 7 days of prior directed antimicrobial treatment had a higher frequency of acute heart failure and emergency surgery, their 30-day and late mortality were compared with patients operated later. In the randomized Early Surgery versus Conventional Treatment for Infective endocarditis (EASE) study, surgery within 48 hours for IE was shown to decrease the composite endpoint of death from any cause and embolic events.…”

Section: Discussionmentioning

confidence: 72%

Outcome of early vs delayed surgery for infective mitral endocarditis

2019

View full text Add to dashboard Cite

Background and aim of the study Timing of surgery for infective endocarditis is controversial. The objective of this study was to report the outcomes of early vs delayed surgery (DS) of mitral endocarditis. Methods We retrospectively reviewed all patients treated surgically for mitral endocarditis between 2005 and 2016 in a single center. We analyzed midterm outcomes of early surgery (ES; surgery within 7 days or less of prior directed antibiotic treatment) in comparison to DS (surgery after more than 7 days of prior directed antibiotic treatment). Results Survival of all patients was 87% at one and 72% at 5 years. Mean follow‐up time was 4.0 ± 3.1 years. Thirty‐three (36.3%) patients were in the ES and 58 (63.7%) were in the DS group. Patients with ES were younger (47.4 vs 55.3 years), were in New York Heart Association class III or IV more frequently (97.0 vs 65.5%), and had higher EuroScore2 (15.6 vs 8.6%). The ES group had lower freedom from valve reoperation (98.2 vs 87.2%; P = .035) and the composite endpoint of >2 + regurgitation or reoperation at 5 years (98.2 vs 72.7%; P = .004). Conclusions ES was associated with a higher rate of reoperations and the composite endpoint of recurrent MR or reoperation.

show abstract

Mortality and timing of surgery in the left-sided infective endocarditis: an Italian multicentre study

Cited by 10 publications

References 30 publications

Endocarditis in the Mediterranean Basin

Endocarditis in the Mediterranean Basin

Epidemiology and risk factors of infective endocarditis in a tertiary hospital in China from 2007 to 2016

Outcome of early vs delayed surgery for infective mitral endocarditis

Contact Info

Product

Resources

About