Predictors of surgical outcome in isolated prosthetic mitral valve endocarditis

Nagy, M; Alkady, Hesham; Senna, Waleed Abo; Abdelhay, Soliman

doi:10.1177/0218492318798258

Cited by 7 publications

(5 citation statements)

References 20 publications

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“…(95% CI 0•5-2•4) of patients (appendix p 24). In children, 44•7% (95% CI 29•5-60•5) of patients with infective endocarditis had congenital heart disease and 26•0% (10•2-45•9) had rheumatic heart disease as underlying cardiac conditions (appendix pp 27-28).21 (50%) of 42 studies reported on clinical and echocardiographic features of infective endocarditis [21][22][23][24][25][26][27][29][30][31][32][33][34][35]38,39,[43][44][45][46]52. These data are summarised in…”

mentioning

confidence: 99%

Epidemiology of infective endocarditis in Africa: a systematic review and meta-analysis

Noubiap

Nkeck

Kwondom³

et al. 2022

The Lancet Global Health

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BackgroundThe epidemiology of infective endocarditis in Africa is inadequately characterised. We therefore aimed to comprehensively summarise the available data for the incidence, risk factors, clinical pattern, microbiology, and outcomes of infective endocarditis in Africa. MethodsWe did a systematic review and meta-analysis. We searched PubMed, Embase, African Index Medicus, and African Journals Online for all studies reporting primary data for the epidemiology of infective endocarditis in populations within Africa, published from inception to Jan 14, 2021, irrespective of the language. We used the search terms "endocarditis", "Africa", and the name of all African countries in the search strategy. We excluded articles that did not include primary data, primary studies with a small sample size (<30 participants), and those that report findings from before 1990. We recorded data for study characteristics, sample size, criteria used to define infective endocarditis, risk factors, potential entry site, clinical patterns, microbiology profile, outcomes including complications such as embolic events, heart failure, acute kidney injury, and death, and predictors of death. We used random-effects meta-analysis method to pool estimates. This study is registered with PROSPERO, CRD42021243842. FindingsWe retrieved 2141 records from the database and bibliographic searches, of which a total of 42 studies were included in this systematic review. Rheumatic heart disease was the most common risk factor for infective endocarditis in adults (52•0% [95% CI 42•4-61•5]), whereas congenital heart disease was the most common risk factor for infective endocarditis in children (44•7% [29•5-60•5]). Microbiological testing (mostly blood cultures) was positive in 48•6% (95% CI 42•2-51•1) of patients with infective endocarditis, with Staphylococcus species (41•3% [95% CI 36•2-46•5]) and Streptococcus species (34•0% [29•0-39•3]) the most commonly identified microorganisms. The pooled rate of surgical treatment of infective endocarditis was 49•1% (95% CI 43•2-55•1). The pooled in-hospital mortality rate was 22•6% (95% CI 19•5-25•9). Other frequent complications included heart failure (47•0% [95% CI 38•2-56•0]), acute kidney injury (22•8% [18•8-27•0]), and embolic events (31•1% [22•2-40•7]). Interpretation As the most prevalent risk factor in Africa, rheumatic heart disease should be central in interventions to reduce the burden of infective endocarditis on the continent. In tertiary hospitals with good access to cardiac surgery, the outcomes of infective endocarditis seem relatively similar to what has been reported in other parts of the world, especially in high-income countries.

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confidence: 99%

Epidemiology of infective endocarditis in Africa: a systematic review and meta-analysis

Noubiap

Nkeck

Kwondom³

et al. 2022

The Lancet Global Health

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“…There are currently no validated scoring models to predict in-hospital complications or outcomes of IE. Current models have focused on long-term outcomes and complications after cardiac surgery [23][24][25]. As demonstrated in this study, the CHA 2 DS 2 -VASc score may serve as a risk assessment tool in patients with IE.…”

Section: Discussionmentioning

confidence: 83%

CHA2DS2-VASc Is Associated With In-Hospital Mortality in Patients With Infective Endocarditis: A Cross-Sectional Cohort Study

Abe

Allie

Eyituoyo

et al. 2020

Cureus

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Background and objective The CHA 2 DS 2-VASc score is a stroke risk stratification tool that is used in patients with atrial fibrillation (AF). Most of its clinical variables have been associated with poor outcomes in patients with infective endocarditis (IE). In this study, we aimed to determine its utility in predicting outcomes in IE patients. Methods We included 35,570 patients with IE from the National Inpatient Sample (NIS), 2009-2012. The CHA 2 DS 2-VASc score was calculated for each patient. Hierarchical logistic regression was used to estimate the adjusted odds ratio for in-hospital mortality for CHA 2 DS 2-VASc scores from 1 to 9, using a score of 0 as the reference score. All clinical characteristics were defined using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Results The mean age of the sample was 57.81 ±14 years. Higher CHA 2 DS 2-VASc scores were associated with increased mortality, and the scores among the sample ranged from 0 for 8.1% to 8 for 21.7%. In the hierarchical logistic regression, after adjusting for age, sex, and relevant comorbidities, as the score increased, so did the odds for overall mortality. Conclusion In patients with IE, the CHA 2 DS 2-VASc score may serve as a risk assessment tool with which to predict outcomes. Further studies are needed to replicate these findings.

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“…Title and abstract screening of the remaining 756 papers led to further exclusion of 675 papers that did not meet our eligibility criteria. Subsequently following full text screening of the 81 papers, only 31 papers were included in the study that met our eligibility criteria 16–46 . The screening process is shown in the PRISMA flow chart in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐analysis on outcomes of valvular heart surgery in Africa

Akintoye,

Musa,

Gyau‐Ampong

et al. 2023

World j. surg.

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IntroductionThe prevalence of valvular heart diseases remain considerably high in Africa, largely but not solely due to rheumatic heart disease. Valvular heart surgeries have emerged as the cornerstone in their management. While several studies have reported data on outcomes following heart valve surgery in many developed countries, there is a staggering paucity of data and evidence reporting the outcomes in the Africa population. The aim of this study is to report the perioperative outcomes following valvular heart surgery in Africa.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta‐analysis guideline was utilized. Electronic searches were performed using PubMed, African journal online, and Research gate from inception to June 2023. The primary endpoints were overall mortality and 30‐day mortality, and secondary endpoints included postoperative complications, length of hospital, and intensive care stays. The outcome data were pooled together and analyzed with the random effect model for proportions and mean for meta‐analysis using the R software.ResultsThis systematic review identified 31 studies that fulfilled the study eligibility criteria and all were observational studies. The countries in which these studies were carried out include South Africa, Ethiopia, Egypt, Mali, Rwanda, Nigeria, Cameroon, Ghana, Senegal, Tanzania, and Kenya. Statistical analysis reported a pooled overall mortality of 10.48% and a pooled 30‐day mortality of 4.59%.ConclusionSeveral obstacles, such as lack of financial resources and inadequate infrastructure, continue to impede valvular heart surgery practice in many parts of Africa. Future studies need to focus on identifying factors associated with this poor early mortality.

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Predictors of surgical outcome in isolated prosthetic mitral valve endocarditis

Cited by 7 publications

References 20 publications

Epidemiology of infective endocarditis in Africa: a systematic review and meta-analysis

Epidemiology of infective endocarditis in Africa: a systematic review and meta-analysis

CHA2DS2-VASc Is Associated With In-Hospital Mortality in Patients With Infective Endocarditis: A Cross-Sectional Cohort Study

A systematic review and meta‐analysis on outcomes of valvular heart surgery in Africa

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