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Khayata M, Grimm RA, Griffin BP, Xu B. Prevalence, Characteristics, and Outcomes of Infective Endocarditis Readmissions in Patients With Variables Associated With Liver Disease in the United States. Angiology 2024:33197241227502. [PMID: 38215273 DOI: 10.1177/00033197241227502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
Infective endocarditis (IE) is common in patients with liver disease. Outcomes of IE in patients with liver disease are limited. We aimed to investigate IE outcomes in patients with variables associated with liver disease in the USA. We used the 2017 National Readmission Database to identify index admission of adults with IE, based on the International Classification of Disease, 10th revision codes. The primary outcome was 30-day readmission. Secondary outcomes were mortality and predictors of hospital readmission. We identified 40,413 IE admissions. Patients who were readmitted were more likely to have a history of HCV (19.4 vs 12.3%, P < .001), hyponatremia (25 vs 21%, P < .001), and thrombocytopenia (20.3 vs 16.3%, P < .001). After adjusting for age, hypertension, heart failure, diabetes mellitus, and end stage renal disease, hyponatremia (odds ratio (OR) 1.25; 95% confidence intervals [CI]: 1.17-1.35; P < .001) and thrombocytopenia (OR 1.16; 95% CI: 1.08-1.24; P < .001) correlated with higher odds of 30-day readmission. Mortality was higher among patients with hyponatremia (29 vs 22%, P < .001), thrombocytopenia (29 vs 17%, P < .001), coagulopathy (12 vs 5%, P < .001), cirrhosis (6 vs 4%, P < .001), ascites (7 vs 3%, P < .001), liver failure (18 vs 3%, P < .001), and portal hypertension (3 vs 1.5%, P < .001).
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Affiliation(s)
- Mohamed Khayata
- Robert and Suzanne Tomsich, Department of Cardiovascular Medicine, Sydnell and Arnold Family Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Richard A Grimm
- Section of Cardiovascular Imaging, Robert and Suzanne Tomsich, Department of Cardiovascular Medicine, Sydnell and Arnold Family Heart, Vascular, and Thoracic Institute, Cleveland, OH, USA
| | - Brian P Griffin
- Section of Cardiovascular Imaging, Robert and Suzanne Tomsich, Department of Cardiovascular Medicine, Sydnell and Arnold Family Heart, Vascular, and Thoracic Institute, Cleveland, OH, USA
| | - Bo Xu
- Section of Cardiovascular Imaging, Robert and Suzanne Tomsich, Department of Cardiovascular Medicine, Sydnell and Arnold Family Heart, Vascular, and Thoracic Institute, Cleveland, OH, USA
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2
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Perek S, Nussinovitch U, Sagi N, Gidron Y, Raz-Pasteur A. Prognostic implications of ultra-short heart rate variability indices in hospitalized patients with infective endocarditis. PLoS One 2023; 18:e0287607. [PMID: 37352199 PMCID: PMC10289432 DOI: 10.1371/journal.pone.0287607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/08/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Infective endocarditis (IE) is a disease that poses a serious health risk. It is important to identify high-risk patients early in the course of their treatment. In the current study, we evaluated the prognostic value of ultra-short heart-rate variability (HRV), an index of vagal nerve activity, in IE. METHODS Retrospective analysis was performed on adult patients admitted to a tertiary hospital due to IE. A logistic regression (LR) was used to determine whether clinical, laboratory, and HRV parameters were predictive of specific clinical features (valve type, staphylococcal infection) or severe short-term complications (cardiac, metastatic infection, and death). The accuracy of the model was evaluated through the measurement of the area under the curve (AUC) of the receiver operating characteristic curve (ROC). An analysis of survival was conducted using Cox regression. A number of HRV indices were calculated, including the standard deviation of normal heart-beat intervals (SDNN) and the root mean square of successive differences (RMSSD). RESULTS 75 patients, aged 60.3(±18.6) years old, were examined. When compared with published age- and gender-adjusted HRV norms, SDNN and RMSSD were found to be relatively low in our cohort (75%-76% lower than the median; 33%-41% lower than the 2nd percentile). 26(34.6%) patients developed a metastatic infection, with RMSSD<7.03ms (adjusted odds ratio (aOR) 9.340, p = 0.002), incorporated in a multivariate LR model (AUC 0.833). Furthermore, 27(36.0%) patients were diagnosed with Staphylococcus IE, with SDNN<4.92ms (aOR 5.235, p = 0.004), a major component of the multivariate LR model (AUC 0.741). Multivariate Cox regression survival model, included RMSSD (HR 1.008, p = 0.012). CONCLUSION SDNN, and particularly RMSSD, derived from ultra-short ECG recordings, may provide prognostic information about patients presenting with IE.
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Affiliation(s)
- Shay Perek
- Department of Internal Medicine A, Rambam Health Care Campus, Haifa, Israel
- Department of Emergency Medicine, Rambam Health Care Campus, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, The Technion–Israel Institute of Technology, Haifa, Israel
| | - Udi Nussinovitch
- Department of Cardiology, Wolfson Medical Center, Holon, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Neta Sagi
- Department of Pediatrics A, Rambam Health Care Campus, Haifa, Israel
| | - Yori Gidron
- Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Ayelet Raz-Pasteur
- Department of Internal Medicine A, Rambam Health Care Campus, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, The Technion–Israel Institute of Technology, Haifa, Israel
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Chien SJ, Tseng YJ, Huang YH, Liu HY, Wu YH, Chang LS, Yang YH, Lin YJ. Evaluation of Infective Endocarditis in Children: A 19-Year Retrospective Study in Taiwan. J Clin Med 2023; 12:jcm12062298. [PMID: 36983299 PMCID: PMC10059053 DOI: 10.3390/jcm12062298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/11/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Abstract
Background: Infective endocarditis (IE) is an important cause of morbidity and mortality in pediatric patients with heart disease. Little literature has explored differences in the presentation of endocarditis in children with and without heart disease. This study aimed to compare the clinical outcomes and determine the risk of in-hospital death in the study population. Methods: Data were retrospectively collected from 2001 to 2019 from the Chang Gung Research Database (CGRD), which is the largest collection of multi-institutional electronic medical records in Taiwan. Children aged 0–20 years with IE were enrolled. We extracted and analyzed the demographic and clinical features, complications, microbiological information, and outcomes of each patient. Results: Of the 208 patients with IE, 114 had heart disease and 94 did not. Compared to those without heart disease, more streptococcal infections (19.3% vs. 2.1%, p < 0.001) and cardiac complications (29.8% vs. 6.4%, p < 0.001) were observed in patients with heart disease. Although patients with heart disease underwent valve surgery more frequently (43.9% vs. 8.5%, p < 0.001) and had longer hospital stays (28.5 vs. 12.5, p = 0.021), their mortality was lower than that of those without heart disease (3.5% vs. 10.6%, p = 0.041). Thrombocytopenia was independent risk factor for in-hospital mortality in pediatric patients with IE (OR = 6.56, 95% CI: 1.43–40.37). Conclusion: Among pediatric patients diagnosed with IE, microbiological and clinical features differed between those with and without heart disease. Platelet counts can be used as a risk factor for in-hospital mortality in pediatric patients with IE.
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Affiliation(s)
- Shao-Ju Chien
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Early Childhood Care and Education, Cheng Shiu University, Kaohsiung 83347, Taiwan
| | - Yi-Ju Tseng
- Department of Computer Science, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Ying-Hua Huang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Hsi-Yun Liu
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Yi-Hua Wu
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Ling-Sai Chang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Yao-Hsu Yang
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Ying-Jui Lin
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Correspondence: or ; Tel.: +886-7-731-7123 (ext. 8795); Fax: +886-7-733-8009
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Hu W, Su G, Zhu W, Zhou E, Shuai X. Systematic Immune-Inflammation Index Predicts Embolic Events in Infective Endocarditis. Int Heart J 2022; 63:510-516. [DOI: 10.1536/ihj.21-627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Wangling Hu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Guanhua Su
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Wanyue Zhu
- Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Enqing Zhou
- First Clinical School, Tongji Medical College, Huazhong University of Science and Technology
| | - Xinxin Shuai
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
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5
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Li Z, Gao Q, Ren Z, Zhou H, Qian Z, Peng J. Nomogram based on neutrophil-to-platelet ratio to predict in-hospital mortality in infective endocarditis. Biomark Med 2021; 15:1233-1243. [PMID: 34488440 DOI: 10.2217/bmm-2021-0085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aim: To develop a nomogram based on neutrophil-to-platelet ratio (NPR) to predict in-hospital mortality in infective endocarditis (IE) patients. Methods: We retrospectively analyzed 294 consecutive patients classified as survivors or nonsurvivors according to hospitalization outcome. Logistic regression analyses were performed to identify independent predictors for in-hospital mortality. A nomogram based on them was established and assessed by receiver operating characteristic (ROC) curve analysis. Results: Admission NPR (odds ratio [OR] = 1.095, 95% CI: 1.037-1.156), positive blood culture (OR = 9.220; 95% CI: 1.478-57.521) and left-sided endocarditis (OR = 5.099; 95% CI: 1.104-23.553) independently predicted in-hospital mortality in IE. The area under the ROC curve for the nomogram based on these predictors was 0.832. Conclusion: The nomogram based on NPR could be used for early risk stratification of IE patients.
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Affiliation(s)
- Zhuohong Li
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qiqing Gao
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zuning Ren
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hao Zhou
- Department of Hospital Infection Management, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhe Qian
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jie Peng
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Evaluation of Laboratory Predictors for In-Hospital Mortality in Infective Endocarditis and Negative Blood Culture Pattern Characteristics. Pathogens 2021; 10:pathogens10050551. [PMID: 34063295 PMCID: PMC8147437 DOI: 10.3390/pathogens10050551] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 04/25/2021] [Accepted: 04/29/2021] [Indexed: 12/27/2022] Open
Abstract
Objective: This study aimed to identify possible differences between blood culture-negative and blood culture-positive groups of infective endocarditis (IE), and explore the associations between biological parameters and in-hospital mortality. Methods: This was a retrospective study of patients hospitalized for IE between 2007 and 2017. Epidemiological, clinical and paraclinical characteristics, by blood culture-negative and positive groups, were collected. The best predictors of in-hospital mortality based on the receiver-operating characteristic (ROC) analysis and AUC (area under the curve) results were identified. Results: A total of 126 IE patients were included, 54% with negative blood cultures at admission. Overall, the in-hospital mortality was 28.6%, higher in the blood culture-negative than positive group (17.5% vs. 11.1%, p = 0.207). A significant increase in the Model for End-Stage Liver Disease Excluding International Normalized Ratio (MELD-XI) score was observed in the blood culture-negative group (p = 0.004), but no baseline characteristics differed between the groups. The best laboratory predictors of in-hospital death in the total study group were the neutrophil count (AUC = 0.824), white blood cell count (AUC = 0.724) and MELD-XI score (AUC = 0.700). Conclusion: Classic laboratory parameters, such as the white blood cell count and neutrophil count, were associated with in-hospital mortality in infective endocarditis. In addition, MELD-XI was a good predictor of in-hospital death.
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Varela L, Vidal L, Fernández-Felix BM, Ventosa G, Navas E, Hidalgo I, Rodríguez-Roda J, Sáez de Ibarra JI, López-Menéndez J. Estimación de la mortalidad quirúrgica de la endocarditis infecciosa: comparación de las diferentes escalas específicas de cálculo de riesgo. CIRUGIA CARDIOVASCULAR 2020. [DOI: 10.1016/j.circv.2020.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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8
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Liu C, Zhou Y, He X, Ma J, Guo W, Dong B, Liang W, Wu Y, Owusu-Agyeman M, Xue R, Zhao J, Wu Z, Dong Y. Mean platelet volume/platelet count ratio predicts long-term mortality in patients with infective endocarditis. Biomark Med 2020; 14:293-302. [PMID: 32166976 DOI: 10.2217/bmm-2019-0258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim: We aimed to examine the association between baseline mean platelet volume/platelet count ratio (MPR) and all-cause mortality in patients with infective endocarditis (IE). Patients & methods: This study analyzed 218 consecutive patients with IE and divided them into four groups based on MPR quartiles. We used Kaplan-Meier survival curves to determine the cumulative survival and Cox proportional hazards models to investigate the association between MPR and all-cause mortality after hospital discharge. Results: Kaplan-Meier curves showed a gradual increase in mortality risk from the lowest MPR quartile to the highest quartile. Multivariate analysis revealed that MPR was an independent predictor of increased risk for all-cause death. Conclusion: Elevated MPR was independently associated with long-term all-cause mortality in patients with IE.
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Affiliation(s)
- Chen Liu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, PR China.,NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou 510080, PR China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, PR China
| | - Yuanyuan Zhou
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, PR China.,NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou 510080, PR China
| | - Xin He
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, PR China.,NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou 510080, PR China
| | - Junxiao Ma
- Sun Yat-sen University Zhongshan School of Medicine, Guangzhou 510080, PR China
| | - Wenyun Guo
- Sun Yat-sen University Zhongshan School of Medicine, Guangzhou 510080, PR China
| | - Bin Dong
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, PR China.,NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou 510080, PR China
| | - Weihao Liang
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, PR China.,NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou 510080, PR China
| | - Yuzhong Wu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, PR China.,NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou 510080, PR China
| | - Marvin Owusu-Agyeman
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, PR China.,NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou 510080, PR China
| | - Ruicong Xue
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, PR China.,NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou 510080, PR China
| | - Jingjing Zhao
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, PR China.,NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou 510080, PR China
| | - Zexuan Wu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, PR China.,NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou 510080, PR China
| | - Yugang Dong
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, PR China.,NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou 510080, PR China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, PR China
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Belletti A, Jacobs S, Affronti G, Mladenow A, Landoni G, Falk V, Schoenrath F. Incidence and Predictors of Postoperative Need for High-Dose Inotropic Support in Patients Undergoing Cardiac Surgery for Infective Endocarditis. J Cardiothorac Vasc Anesth 2018; 32:2528-2536. [DOI: 10.1053/j.jvca.2017.12.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Indexed: 12/15/2022]
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10
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Varela Barca L, López-Menéndez J, Navas Elorza E, Moya Mur JL, Centella Hernéndez T, Redondo Palacios A, Fajardo ER, Miguelena Hycka J, Martín García M, Muñoz Pérez R, Rodríguez-Roda Stuart J. Long-term prognosis after surgery for infective endocarditis: Distinction between predictors of early and late survival. Enferm Infecc Microbiol Clin 2018; 37:435-440. [PMID: 30470460 DOI: 10.1016/j.eimc.2018.10.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/13/2018] [Accepted: 10/16/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Cardiac surgery is a life-saving procedure in patients diagnosed with infective endocarditis (IE). There are several validated risk scores developed to predict early-mortality; nevertheless, long-term survival has been less investigated. The aim of the present study is to analyze the impact of IE-specific risk factors for early and long-term mortality. METHODS An observational retrospective study was conducted that included all patients who underwent surgery for IE from 2002 to 2016. Median follow-up time after surgery was 53.2 months (IQI 26.2-106.8 months). In-hospital mortality was analyzed using multiple logistic regression. Long-term survival was analyzed after one, two and five years. Cox proportional hazards regression was employed to identify risk factors related to long-term mortality. RESULTS Of the 180 patients underwent cardiac surgery, 133 were discharged alive (in-hospital mortality was 26.11%). 6 variables were identified as independent factors associated with in-hospital mortality, most of them closely related to the severity of IE: age, multivalvular involvement, critical preoperative status, preoperative mechanical ventilation, abscess and thrombocytopenia. Long-term survival in patients discharged alive was 89.1%, 87.4% and 77.6% after one, two and five years. Long-term mortality was independent of specific IE factors and 86.51% of deaths were not related to cardiovascular or infectious diseases. CONCLUSION Despite the high perioperative mortality rate after surgical treatment for active IE, long-term survival after hospital discharge was acceptable, regardless of the severity of the endocarditis episode. Although in-hospital survival depended mainly on several IE factors, long-term survival was not related to the severity of endocarditis baseline affection.
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11
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Valor pronóstico de la trombocitopenia preoperatoria en la cirugía de la endocarditis infecciosa: experiencia de un centro. CIRUGIA CARDIOVASCULAR 2018. [DOI: 10.1016/j.circv.2018.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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12
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Stein E, Andritsos M. Risk Stratification and Optimization of Cardiac Surgical Patients With Infective Endocarditis: Does It Matter? J Cardiothorac Vasc Anesth 2018; 32:2537-2539. [PMID: 29929896 DOI: 10.1053/j.jvca.2018.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Erica Stein
- Department of Anesthesiology, The Ohio State University, Columbus, Ohio
| | - Michael Andritsos
- Department of Anesthesiology, The Ohio State University, Columbus, Ohio
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13
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Wei XB, Liu YH, He PC, Yu DQ, Tan N, Zhou YL, Chen JY. The impact of admission neutrophil-to-platelet ratio on in-hospital and long-term mortality in patients with infective endocarditis. Clin Chem Lab Med 2017; 55:899-906. [PMID: 27987356 DOI: 10.1515/cclm-2016-0527] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 10/31/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Infective endocarditis (IE) is associated with increased neutrophil and reduced platelet counts. We assessed the relationship between the neutrophil-to-platelet ratio (NPR) on admission and adverse outcomes in patients with IE. METHODS Patients diagnosed with IE between January 2009 and July 2015 (n=1293) were enrolled, and 1046 were finally entered into the study. Study subjects were categorized into four groups according to NPR quartiles: Q1<18.9 (n=260); Q2: 18.9-27.7 (n=258); Q3: 27.7-43.3 (n=266); and Q4>43.3 (n=262). Cox proportional hazards regression was performed to identify risk factors for long-term mortality; the optimal cut-off was evaluated by receiver operating characteristic curves. RESULTS Risk of in-hospital death increased progressively with NPR group number (1.9 vs. 5.0 vs. 9.8 vs. 14.1%, p<0.001). The follow-up period was a median of 28.8 months, during which 144 subjects (14.3%) died. Long-term mortality increased from the lowest to the highest NPR quartiles (7.6, 11.8, 17.4, and 26.2%, respectively, p<0.001). Multivariate Cox proportional hazard analysis revealed that lgNPR (HR=2.22) was an independent predictor of long-term mortality. Kaplan-Meier survival curves showed that subjects in Q4 had an increased long-term mortality compared with the other groups. CONCLUSIONS Increased NPR was associated with in-hospital and long-term mortality in patients with IE. As a simple and inexpensive index, NPR may be a useful and rapid screening tool to identify IE patients at high risk of mortality.
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Affiliation(s)
- Xue-Biao Wei
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P.R
| | - Yuan-Hui Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P.R
| | - Peng-Cheng He
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P.R
| | - Dan-Qing Yu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P.R
| | - Ning Tan
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P.R
| | - Ying-Ling Zhou
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P.R
| | - Ji-Yan Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P.R
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Olmos C, Vilacosta I, Habib G, Maroto L, Fernández C, López J, Sarriá C, Salaun E, Di Stefano S, Carnero M, Hubert S, Ferrera C, Tirado G, Freitas-Ferraz A, Sáez C, Cobiella J, Bustamante-Munguira J, Sánchez-Enrique C, García-Granja PE, Lavoute C, Obadia B, Vivas D, Gutiérrez Á, San Román JA. Risk score for cardiac surgery in active left-sided infective endocarditis. Heart 2017; 103:1435-1442. [DOI: 10.1136/heartjnl-2016-311093] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/06/2017] [Accepted: 03/08/2017] [Indexed: 11/03/2022] Open
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