Abstract
Background-Use of surgery for the treatment of infective endocarditis (IE) as related to surgical indications and operative risk for mortality has not been well defined. Methods and Results-The International Collaboration on Endocarditis-PLUS (ICE-PLUS) is a prospective cohort of consecutively enrolled patients with definite IE from 29 centers in 16 countries. We included patients from ICE-PLUS with definite left-sided, non-cardiac device-related IE who were enrolled between September 1, 2008, and December 31, 2012. A total of 1296 patients with left-sided IE were included. Surgical treatment was performed in 57% of the overall cohort and in 76% of patients with a surgical indication. Reasons for nonsurgical treatment included poor prognosis (33.7%), hemodynamic instability (19.8%), death before surgery (23.3%), stroke (22.7%), and sepsis (21%). Among patients with a surgical indication, surgical treatment was independently associated with the presence of severe aortic regurgitation, abscess, embolization before surgical treatment, and transfer from an outside hospital. Variables associated with nonsurgical treatment were a history of moderate/severe liver disease, stroke before surgical decision, and Staphyloccus aureus etiology. The integration of surgical indication, Society of Thoracic Surgeons IE score, and use of surgery was associated with 6-month survival in IE. Conclusions-Surgical decision making in IE is largely consistent with established guidelines, although nearly one quarter of patients with surgical indications do not undergo surgery. Operative risk assessment by Society of Thoracic Surgeons IE score provides prognostic information for survival beyond the operative period. S aureus IE was significantly associated with nonsurgical management.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 131-140 |
| Number of pages | 10 |
| Journal | Circulation |
| Volume | 131 |
| Issue number | 2 |
| DOIs | |
| State | Published - 2015 |
Keywords
- Endocarditis
- Infection
- Mortality
- Surgery
- Valve
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)
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In: Circulation, Vol. 131, No. 2, 2015, p. 131-140.
Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Association between surgical indications, operative risk, and clinical outcome in infective endocarditis a prospective study from the international collaboration on endocarditis
AU - Chu, Vivian H.
AU - Park, Lawrence P.
AU - Athan, Eugene
AU - Delahaye, Francois
AU - Freiberger, Tomas
AU - Lamas, Cristiane
AU - Miro, Jose M.
AU - Mudrick, Daniel W.
AU - Strahilevitz, Jacob
AU - Tribouilloy, Christophe
AU - Durante-Mangoni, Emanuele
AU - Pericas, Juan M.
AU - Fernández-Hidalgo, Nuria
AU - Nacinovich, Francisco
AU - Rizk, Hussien
AU - Krajinovic, Vladimir
AU - Giannitsioti, Efthymia
AU - Hurley, John P.
AU - Hannan, Margaret M.
AU - Wang, Andrew
AU - Clara, Liliana
AU - Sanchez, Marisa
AU - Casabé, José
AU - Cortes, Claudia
AU - Oses, Pablo Fernandez
AU - Ronderos, Ricardo
AU - Sucari, Adriana
AU - Thierer, Jorge
AU - Altclas, Javier
AU - Kogan, Silvia
AU - Spelman, Denis
AU - Harris, Owen
AU - Kennedy, Karina
AU - Tan, Ren
AU - Gordon, David
AU - Korman, Tony
AU - Kotsanas, Despina
AU - Dever, Robyn
AU - Jones, Phillip
AU - Konecny, Pam
AU - Lawrence, Richard
AU - Rees, David
AU - Ryan, Suzanne
AU - Feneley, Michael P.
AU - Harkness, John
AU - Post, Jeffrey
AU - Reinbott, Porl
AU - Gattringer, Rainer
AU - Wiesbauer, Franz
AU - Andrade, Adriana Ribas
AU - de Brito, Ana Cláudia Passos
AU - Guimarães, Armenio Costa
AU - Grinberg, Max
AU - Mansur, Alfredo José
AU - Siciliano, Rinaldo Focaccia
AU - Strabelli, Tania Mara Varejao
AU - Vieira, Marcelo Luiz Campos
AU - de Medeiros Tranchesi, Regina Aparecida
AU - Paiva, Marcelo Goulart
AU - Fortes, Claudio Querido
AU - de Oliveira Ramos, Auristela
AU - Ferraiuoli, Giovanna
AU - Golebiovski, Wilma
AU - Weksler, Clara
AU - Karlowsky, James A.
AU - Keynan, Yoav
AU - Morris, Andrew M.
AU - Rubinstein, Ethan
AU - Jones, Sandra Braun
AU - Garcia, Patricia
AU - Cereceda, M.
AU - Fica, Alberto
AU - Fernandez, Ricardo
AU - Franco, Liliana
AU - Gonzalez, Javier
AU - Jaramillo, Astrid Natalia
AU - Barsic, Bruno
AU - Bukovski, Suzana
AU - Rudez, Igor
AU - Vincelj, Josip
AU - Pol, Jiri
AU - Malisova, Barbora
AU - Ashour, Zainab
AU - El Kholy, Amani
AU - Mishaal, Marwa
AU - Osama, Dina
AU - Aissa, Neijla
AU - Alauzet, Corentine
AU - Alla, Francois
AU - Campagnac, Catherine
AU - Doco-Lecompte, Thanh
AU - Selton-Suty, Christine
AU - Casalta, Jean Paul
AU - Fournier, Pierre Edouard
AU - Habib, Gilbert
AU - Raoult, Didier
AU - Thuny, Franck
AU - Delahaye, Armelle
AU - Vandenesch, Francois
AU - Donal, Erwan
AU - Donnio, Pierre Yves
AU - Flecher, Erwan
AU - Michelet, Christian
AU - Revest, Matthieu
AU - Tattevin, Pierre
AU - Chevalier, Florent
AU - Jeu, Antoine
AU - Rémadi, Jean Paul
AU - Rusinaru, Dan
AU - Bernard, Yvette
AU - Chirouze, Catherine
AU - Hoen, Bruno
AU - Leroy, Joel
AU - Plesiat, Patrick
AU - Naber, Christoph
AU - Neuerburg, Carl
AU - Mazaheri, Bahram
AU - Athanasia, Sofia
AU - Giamarellou, Helen
AU - Thomas, Tsaganos
AU - Mylona, Elena
AU - Paniara, Olga
AU - Papanicolaou, Konstantinos
AU - Pyros, John
AU - Skoutelis, Athanasios
AU - Papanikolaou, Konstantinos
AU - Sharma, Gautam
AU - Francis, Johnson
AU - Nair, Lathi
AU - Thomas, Vinod
AU - Venugopal, Krishnan
AU - Cahan, Amos
AU - Gilon, Dan
AU - Israel, Sarah
AU - Korem, Maya
AU - Mattucci, Irene
AU - Pinto, Daniela
AU - Agrusta, Federica
AU - Senese, Alessandra
AU - Ragone, Enrico
AU - Utili, Riccardo
AU - Cecchi, Enrico
AU - De Rosa, Francesco
AU - Forno, Davide
AU - Imazio, Massimo
AU - Trinchero, Rita
AU - Grossi, Paolo
AU - Lattanzio, Mariangela
AU - Toniolo, Antonio
AU - Goglio, Antonio
AU - Raglio, Annibale
AU - Ravasio, Veronica
AU - Rizzi, Marco
AU - Suter, Fredy
AU - Carosi, Giampiero
AU - Magri, Silvia
AU - Signorini, Liana
AU - Kanafani, Zeina
AU - Kanj, Souha S.
AU - Sharif-Yakan, Ahmad
AU - Abidin, Imran
AU - Tamin, Syahidah Syed
AU - Martínez, Eduardo Rivera
AU - Nieto, Gabriel Israel Soto
AU - van der Meer, Jan T.M.
AU - Chambers, Stephen
AU - Holland, David
AU - Morris, Arthur
AU - Raymond, Nigel
AU - Read, Kerry
AU - Murdoch, David R.
AU - Dragulescu, Stefan
AU - Ionac, Adina
AU - Mornos, Cristian
AU - Butkevich, O. M.
AU - Chipigina, Natalia
AU - Kirill, Ozerecky
AU - Vadim, Kulichenko
AU - Vinogradova, Tatiana
AU - Edathodu, Jameela
AU - Halim, Magid
AU - Liew, Yee Yun
AU - Tan, Ru San
AU - Lejko-Zupanc, Tatjana
AU - Logar, Mateja
AU - Mueller-Premru, Manica
AU - Commerford, Patrick
AU - Commerford, Anita
AU - Deetlefs, Eduan
AU - Hansa, Cass
AU - Ntsekhe, Mpiko
AU - Almela, Manuel
AU - Armero, Yolanda
AU - Azqueta, Manuel
AU - Castañeda, Ximena
AU - Cervera, Carlos
AU - Falces, Carlos
AU - Garcia-dela-Maria, Cristina
AU - Fita, Guillermina
AU - Gatell, Jose M.
AU - Heras, Magda
AU - Llopis, Jaime
AU - Marco, Francesc
AU - Mestres, Carlos A.
AU - Miró, José M.
AU - Moreno, Asuncion
AU - Ninot, Salvador
AU - Paré, Carlos
AU - Ramirez, Jose
AU - Rovira, Irene
AU - Sitges, Marta
AU - Anguera, Ignasi
AU - Font, Bernat
AU - Guma, Joan Raimon
AU - Bermejo, Javier
AU - Bouza, Emilio
AU - Fernández, Miguel Angel Garcia
AU - Gonzalez-Ramallo, Victor
AU - Marín, Mercedes
AU - Muñoz, Patricia
AU - Pedromingo, Miguel
AU - Roda, Jorge
AU - Rodríguez-Créixems, Marta
AU - Solis, Jorge
AU - Almirante, Benito
AU - Tornos, Pilar
AU - de Alarcón, Arístides
AU - Parra, Ricardo
AU - Alestig, Eric
AU - Johansson, Magnus
AU - Olaison, Lars
AU - Snygg-Martin, Ulrika
AU - Pachirat, Orathai
AU - Pachirat, Pimchitra
AU - Pussadhamma, Burabha
AU - Senthong, Vichai
AU - Casey, Anna
AU - Elliott, Tom
AU - Lambert, Peter
AU - Watkin, Richard
AU - Eyton, Christina
AU - Klein, John L.
AU - Bradley, Suzanne
AU - Kauffman, Carol
AU - Bedimo, Roger
AU - Corey, G. Ralph
AU - Crowley, Anna Lisa
AU - Douglas, Pamela
AU - Drew, Laura
AU - Fowler, Vance G.
AU - Holland, Thomas
AU - Lalani, Tahaniyat
AU - Samad, Zaniab
AU - Sexton, Daniel J.
AU - Stryjewski, Martin
AU - Woods, Christopher W.
AU - Lerakis, Stamatios
AU - Cantey, Robert
AU - Steed, Lisa
AU - Wray, Dannah
AU - Dickerman, Stuart A.
AU - Bonilla, Hector
AU - DiPersio, Joseph
AU - Salstrom, Sara Jane
AU - Baddley, John
AU - Patel, Mukesh
AU - Peterson, Gail
AU - Stancoven, Amy
AU - Levine, Donald
AU - Riddle, Jonathan
AU - Rybak, Michael
AU - Cabell, Christopher H.
AU - Baloch, Khaula
AU - Dixon, Christy C.
AU - Harding, Tina
AU - Jones-Richmond, Marian
AU - Sanderford, Bob
AU - Stafford, Judy
AU - Anstrom, Kevin
AU - Bayer, Arnold S.
AU - Karchmer, A. W.
AU - Durack, David T.
AU - Eykyn, Susannah
AU - Moreillon, Phillipe
N1 - Publisher Copyright: © 2014 American Heart Association, Inc.
PY - 2015
Y1 - 2015
N2 - Background-Use of surgery for the treatment of infective endocarditis (IE) as related to surgical indications and operative risk for mortality has not been well defined. Methods and Results-The International Collaboration on Endocarditis-PLUS (ICE-PLUS) is a prospective cohort of consecutively enrolled patients with definite IE from 29 centers in 16 countries. We included patients from ICE-PLUS with definite left-sided, non-cardiac device-related IE who were enrolled between September 1, 2008, and December 31, 2012. A total of 1296 patients with left-sided IE were included. Surgical treatment was performed in 57% of the overall cohort and in 76% of patients with a surgical indication. Reasons for nonsurgical treatment included poor prognosis (33.7%), hemodynamic instability (19.8%), death before surgery (23.3%), stroke (22.7%), and sepsis (21%). Among patients with a surgical indication, surgical treatment was independently associated with the presence of severe aortic regurgitation, abscess, embolization before surgical treatment, and transfer from an outside hospital. Variables associated with nonsurgical treatment were a history of moderate/severe liver disease, stroke before surgical decision, and Staphyloccus aureus etiology. The integration of surgical indication, Society of Thoracic Surgeons IE score, and use of surgery was associated with 6-month survival in IE. Conclusions-Surgical decision making in IE is largely consistent with established guidelines, although nearly one quarter of patients with surgical indications do not undergo surgery. Operative risk assessment by Society of Thoracic Surgeons IE score provides prognostic information for survival beyond the operative period. S aureus IE was significantly associated with nonsurgical management.
AB - Background-Use of surgery for the treatment of infective endocarditis (IE) as related to surgical indications and operative risk for mortality has not been well defined. Methods and Results-The International Collaboration on Endocarditis-PLUS (ICE-PLUS) is a prospective cohort of consecutively enrolled patients with definite IE from 29 centers in 16 countries. We included patients from ICE-PLUS with definite left-sided, non-cardiac device-related IE who were enrolled between September 1, 2008, and December 31, 2012. A total of 1296 patients with left-sided IE were included. Surgical treatment was performed in 57% of the overall cohort and in 76% of patients with a surgical indication. Reasons for nonsurgical treatment included poor prognosis (33.7%), hemodynamic instability (19.8%), death before surgery (23.3%), stroke (22.7%), and sepsis (21%). Among patients with a surgical indication, surgical treatment was independently associated with the presence of severe aortic regurgitation, abscess, embolization before surgical treatment, and transfer from an outside hospital. Variables associated with nonsurgical treatment were a history of moderate/severe liver disease, stroke before surgical decision, and Staphyloccus aureus etiology. The integration of surgical indication, Society of Thoracic Surgeons IE score, and use of surgery was associated with 6-month survival in IE. Conclusions-Surgical decision making in IE is largely consistent with established guidelines, although nearly one quarter of patients with surgical indications do not undergo surgery. Operative risk assessment by Society of Thoracic Surgeons IE score provides prognostic information for survival beyond the operative period. S aureus IE was significantly associated with nonsurgical management.
KW - Endocarditis
KW - Infection
KW - Mortality
KW - Surgery
KW - Valve
UR - http://www.scopus.com/inward/record.url?scp=84925285609&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84925285609&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.114.012461
DO - 10.1161/CIRCULATIONAHA.114.012461
M3 - Article
C2 - 25480814
AN - SCOPUS:84925285609
SN - 0009-7322
VL - 131
SP - 131
EP - 140
JO - Circulation
JF - Circulation
IS - 2
ER -