| Predictors of death and impact of surgery in Staphylococcus aureus infective endocarditis. | |
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MedLine Citation:
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PMID: 17383330 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: We studied a large cohort of adults with Staphylococcus aureus infective endocarditis to evaluate the predictors of outcome and to establish whether early surgery is associated with reduced mortality. METHODS: The study prospectively enrolled 116 consecutive patients with definite S. aureus infective endocarditis, according to Duke criteria and examined by transthoracic and transesophageal echocardiography. RESULTS: The in-hospital mortality rate was 26%, and the 36-month survival rate was 57% +/- 5%. Multivariate analyses identified comorbidity index, congestive heart failure, severe sepsis, prosthetic valve infective endocarditis, and major neurologic events as predictors of in-hospital mortality; severe sepsis and comorbidity index as predictors of overall mortality; and the comorbidity index as a predictor of late mortality. In unadjusted analyses, early surgery performed in 47% of patients was associated with lower in-hospital mortality (16% versus 34%; p = 0.034) and with better 36-month survival (77% +/- 6% versus 39% +/- 7%; p < 0.001). After adjustment of baseline variables related to mortality, early surgery remained associated with reduced overall mortality. CONCLUSIONS: Prognosis of S. aureus infective endocarditis remains poor, related to the comorbidities, presence of congestive heart failure, severe sepsis, major neurologic events, and prosthetic valve. Early surgery is independently associated with reduced overall mortality and should be considered in selected cases to improve the outcome. |
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Authors:
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Jean Paul Remadi; Gilbert Habib; Georges Nadji; Amel Brahim; Franck Thuny; Jean Paul Casalta; Marcel Peltier; Christophe Tribouilloy |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 83 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-03-26 Completed Date: 2007-04-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 1295-302 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiovascular Disease, INSERM, ERI-12 CHU, Amiens, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Analysis of Variance Anti-Bacterial Agents / therapeutic use Cardiac Surgical Procedures / methods, mortality* Cause of Death* Echocardiography, Transesophageal Endocarditis, Bacterial / drug therapy, mortality*, surgery*, ultrasonography Female Follow-Up Studies Hospital Mortality / trends Humans Male Middle Aged Predictive Value of Tests Probability Prospective Studies Risk Assessment Severity of Illness Index Staphylococcal Infections / diagnosis*, mortality*, therapy Staphylococcus aureus / isolation & purification Survival Analysis Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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