Influence of the timing of cardiac surgery on the outcome of patients with infective endocarditis and stroke. - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Clinical Infectious Diseases Année : 2013

Influence of the timing of cardiac surgery on the outcome of patients with infective endocarditis and stroke.

Bruno Barsic
  • Fonction : Auteur correspondant
  • PersonId : 947211

Connectez-vous pour contacter l'auteur
Stuart Dickerman
  • Fonction : Auteur
Vladimir Krajinovic
  • Fonction : Auteur
Paul Pappas
  • Fonction : Auteur
Javier Altclas
  • Fonction : Auteur
Giampiero Carosi
  • Fonction : Auteur
José H Casabé
  • Fonction : Auteur
Vivian H Chu
  • Fonction : Auteur
Jameela Edathodu
  • Fonction : Auteur
Claudio Querido Fortes
  • Fonction : Auteur
Lars Olaison
  • Fonction : Auteur
Ana Pangercic
  • Fonction : Auteur
Mukesh Patel
  • Fonction : Auteur
Igor Rudez
  • Fonction : Auteur
Syahidah Syed Tamin
  • Fonction : Auteur
Josip Vincelj
  • Fonction : Auteur
Arnold S Bayer
  • Fonction : Auteur
Andrew Wang
  • Fonction : Auteur

Résumé

BACKGROUND: The timing of cardiac surgery after stroke in infective endocarditis (IE) remains controversial. We examined the relationship between the timing of surgery after stroke and the incidence of in-hospital and 1-year mortalities. METHODS: Data were obtained from the International Collaboration on Endocarditis-Prospective Cohort Study of 4794 patients with definite IE who were admitted to 64 centers from June 2000 through December 2006. Multivariate logistic regression and Cox regression analyses were performed to estimate the impact of early surgery on hospital and 1-year mortality after adjustments for other significant covariates. RESULTS: Of the 857 patients with IE complicated by ischemic stroke syndromes, 198 who underwent valve replacement surgery poststroke were available for analysis. Overall, 58 (29.3%) patients underwent early surgical treatment vs 140 (70.7%) patients who underwent late surgical treatment. After adjustment for other risk factors, early surgery was not significantly associated with increased in-hospital mortality rates (odds ratio, 2.308; 95% confidence interval [CI], .942-5.652). Overall, probability of death after 1-year follow-up did not differ between 2 treatment groups (27.1% in early surgery and 19.2% in late surgery group, P = .328; adjusted hazard ratio, 1.138; 95% CI, .802-1.650). CONCLUSIONS: There is no apparent survival benefit in delaying surgery when indicated in IE patients after ischemic stroke. Further observational analyses that include detailed pre- and postoperative clinical neurologic findings and advanced imaging data (eg, ischemic stroke size), may allow for more refined recommendations on the optimal timing of valvular surgery in patients with IE and recent stroke syndromes.

Mots clés

Dates et versions

hal-00875143 , version 1 (21-10-2013)

Identifiants

Citer

Bruno Barsic, Stuart Dickerman, Vladimir Krajinovic, Paul Pappas, Javier Altclas, et al.. Influence of the timing of cardiac surgery on the outcome of patients with infective endocarditis and stroke.. Clinical Infectious Diseases, 2013, 56 (2), pp.209-17. ⟨10.1093/cid/cis878⟩. ⟨hal-00875143⟩
215 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More