Association between surgical indications, operative risk, and clinical outcome in infective endocarditis a prospective study from the international collaboration on endocarditis

Vivian H. Chu, Lawrence P. Park, Eugene Athan, Francois Delahaye, Tomas Freiberger, Cristiane Lamas, Jose M. Miro, Daniel W. Mudrick, Jacob Strahilevitz, Christophe Tribouilloy, Emanuele Durante-Mangoni, Juan M. Pericas, Nuria Fernández-Hidalgo, Francisco Nacinovich, Hussien Rizk, Vladimir Krajinovic, Efthymia Giannitsioti, John P. Hurley, Margaret M. Hannan, Andrew WangLiliana Clara, Marisa Sanchez, José Casabé, Claudia Cortes, Pablo Fernandez Oses, Ricardo Ronderos, Adriana Sucari, Jorge Thierer, Javier Altclas, Silvia Kogan, Denis Spelman, Owen Harris, Karina Kennedy, Ren Tan, David Gordon, Tony Korman, Despina Kotsanas, Robyn Dever, Phillip Jones, Pam Konecny, Richard Lawrence, David Rees, Suzanne Ryan, Michael P. Feneley, John Harkness, Jeffrey Post, Porl Reinbott, Rainer Gattringer, Franz Wiesbauer, Adriana Ribas Andrade, Ana Cláudia Passos de Brito, Armenio Costa Guimarães, Max Grinberg, Alfredo José Mansur, Rinaldo Focaccia Siciliano, Tania Mara Varejao Strabelli, Marcelo Luiz Campos Vieira, Regina Aparecida de Medeiros Tranchesi, Marcelo Goulart Paiva, Claudio Querido Fortes, Auristela de Oliveira Ramos, Giovanna Ferraiuoli, Wilma Golebiovski, Clara Weksler, James A. Karlowsky, Yoav Keynan, Andrew M. Morris, Ethan Rubinstein, Sandra Braun Jones, Patricia Garcia, M. Cereceda, Alberto Fica, Ricardo Fernandez, Liliana Franco, Javier Gonzalez, Astrid Natalia Jaramillo, Bruno Barsic, Suzana Bukovski, Igor Rudez, Josip Vincelj, Jiri Pol, Barbora Malisova, Zainab Ashour, Amani El Kholy, Marwa Mishaal, Dina Osama, Neijla Aissa, Corentine Alauzet, Francois Alla, Catherine Campagnac, Thanh Doco-Lecompte, Christine Selton-Suty, Jean Paul Casalta, Pierre Edouard Fournier, Gilbert Habib, Didier Raoult, Franck Thuny, Armelle Delahaye, Francois Vandenesch, Erwan Donal, Pierre Yves Donnio, Erwan Flecher, Christian Michelet, Matthieu Revest, Pierre Tattevin, Florent Chevalier, Antoine Jeu, Jean Paul Rémadi, Dan Rusinaru, Yvette Bernard, Catherine Chirouze, Bruno Hoen, Joel Leroy, Patrick Plesiat, Christoph Naber, Carl Neuerburg, Bahram Mazaheri, Sofia Athanasia, Helen Giamarellou, Tsaganos Thomas, Elena Mylona, Olga Paniara, Konstantinos Papanicolaou, John Pyros, Athanasios Skoutelis, Konstantinos Papanikolaou, Gautam Sharma, Johnson Francis, Lathi Nair, Vinod Thomas, Krishnan Venugopal, Amos Cahan, Dan Gilon, Sarah Israel, Maya Korem, Irene Mattucci, Daniela Pinto, Federica Agrusta, Alessandra Senese, Enrico Ragone, Riccardo Utili, Enrico Cecchi, Francesco De Rosa, Davide Forno, Massimo Imazio, Rita Trinchero, Paolo Grossi, Mariangela Lattanzio, Antonio Toniolo, Antonio Goglio, Annibale Raglio, Veronica Ravasio, Marco Rizzi, Fredy Suter, Giampiero Carosi, Silvia Magri, Liana Signorini, Zeina Kanafani, Souha S. Kanj, Ahmad Sharif-Yakan, Imran Abidin, Syahidah Syed Tamin, Eduardo Rivera Martínez, Gabriel Israel Soto Nieto, Jan T.M. van der Meer, Stephen Chambers, David Holland, Arthur Morris, Nigel Raymond, Kerry Read, David R. Murdoch, Stefan Dragulescu, Adina Ionac, Cristian Mornos, O. M. Butkevich, Natalia Chipigina, Ozerecky Kirill, Kulichenko Vadim, Tatiana Vinogradova, Jameela Edathodu, Magid Halim, Yee Yun Liew, Ru San Tan, Tatjana Lejko-Zupanc, Mateja Logar, Manica Mueller-Premru, Patrick Commerford, Anita Commerford, Eduan Deetlefs, Cass Hansa, Mpiko Ntsekhe, Manuel Almela, Yolanda Armero, Manuel Azqueta, Ximena Castañeda, Carlos Cervera, Carlos Falces, Cristina Garcia-dela-Maria, Guillermina Fita, Jose M. Gatell, Magda Heras, Jaime Llopis, Francesc Marco, Carlos A. Mestres, José M. Miró, Asuncion Moreno, Salvador Ninot, Carlos Paré, Jose Ramirez, Irene Rovira, Marta Sitges, Ignasi Anguera, Bernat Font, Joan Raimon Guma, Javier Bermejo, Emilio Bouza, Miguel Angel Garcia Fernández, Victor Gonzalez-Ramallo, Mercedes Marín, Patricia Muñoz, Miguel Pedromingo, Jorge Roda, Marta Rodríguez-Créixems, Jorge Solis, Benito Almirante, Pilar Tornos, Arístides de Alarcón, Ricardo Parra, Eric Alestig, Magnus Johansson, Lars Olaison, Ulrika Snygg-Martin, Orathai Pachirat, Pimchitra Pachirat, Burabha Pussadhamma, Vichai Senthong, Anna Casey, Tom Elliott, Peter Lambert, Richard Watkin, Christina Eyton, John L. Klein, Suzanne Bradley, Carol Kauffman, Roger J Bedimo, G. Ralph Corey, Anna Lisa Crowley, Pamela Douglas, Laura Drew, Vance G. Fowler, Thomas Holland, Tahaniyat Lalani, Zaniab Samad, Daniel J. Sexton, Martin Stryjewski, Christopher W. Woods, Stamatios Lerakis, Robert Cantey, Lisa Steed, Dannah Wray, Stuart A. Dickerman, Hector Bonilla, Joseph DiPersio, Sara Jane Salstrom, John Baddley, Mukesh Patel, Gail E Peterson, Amy Stancoven, Donald Levine, Jonathan Riddle, Michael Rybak, Christopher H. Cabell, Khaula Baloch, Christy C. Dixon, Tina Harding, Marian Jones-Richmond, Bob Sanderford, Judy Stafford, Kevin Anstrom, Arnold S. Bayer, A. W. Karchmer, David T. Durack, Susannah Eykyn, Phillipe Moreillon

Research output: Contribution to journalArticle

98 Scopus citations

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 languageEnglish (US)
Pages (from-to)131-140
Number of pages10
JournalCirculation
Volume131
Issue number2
DOIs
StatePublished - Jan 1 2015

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Keywords

  • Endocarditis
  • Infection
  • Mortality
  • Surgery
  • Valve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Chu, V. H., Park, L. P., Athan, E., Delahaye, F., Freiberger, T., Lamas, C., Miro, J. M., Mudrick, D. W., Strahilevitz, J., Tribouilloy, C., Durante-Mangoni, E., Pericas, J. M., Fernández-Hidalgo, N., Nacinovich, F., Rizk, H., Krajinovic, V., Giannitsioti, E., Hurley, J. P., Hannan, M. M., ... Moreillon, P. (2015). Association between surgical indications, operative risk, and clinical outcome in infective endocarditis a prospective study from the international collaboration on endocarditis. Circulation, 131(2), 131-140. https://doi.org/10.1161/CIRCULATIONAHA.114.012461