Differences in mortality in patients undergoing surgery for infective endocarditis according to age and valvular surgery
Posted on 2020-09-26 - 03:26
Abstract Background Infective endocarditis (IE) is associated with high mortality. Surgery may improve survival and reduce complications, but the balance between benefit and harm is difficult and may be closely related to age and type of surgical intervention. We aimed to examine how age and type of left-sided surgical intervention modified mortality in patients undergoing surgery for IE. Methods By crosslinking nationwide Danish registries we identified patients with first-time IE undergoing surgical treatment 2000–2017. Patients were grouped by age < 60 years, 60–75 years, and ≥ 75 years. Multivariable adjusted Cox proportional hazard analysis was used to examine factors associated with 90-day mortality. Results We included 1767 patients with IE undergoing surgery, 735 patients < 60 years (24.1% female), 766 patients 60–75 years (25.8% female), and 266 patients ≥75 years (36.1% female). The proportions of patients undergoing surgery were 35.3, 26.9, and 9.1% for patients < 60 years, 60–75 years, and > 75 years, respectively. Mortality at 90 days were 7.5, 13.9, and 22.3% (p < 0.001) for three age groups. In adjusted analyses, patients 60–75 years and patients ≥75 years were associated with a higher mortality, HR = 1.84 (95% CI: 1.48–2.29) and HR = 2.47 (95% CI: 1.88–3.24) as compared with patients < 60 years. Factors associated with 90-day mortality were: mitral valve surgery, a combination of mitral and aortic valve surgery as compared with isolated aortic valve surgery, age, diabetes, and prosthetic heart valve implantation prior to IE admission. Conclusions In patients undergoing surgery for IE, mortality increased significantly with age and 1 in 5 died above age 75 years. Mitral valve surgery as well as multiple valve interventions augmented mortality further.
CITE THIS COLLECTION
DataCite
3 Biotech
3D Printing in Medicine
3D Research
3D-Printed Materials and Systems
4OR
AAPG Bulletin
AAPS Open
AAPS PharmSciTech
Abhandlungen aus dem Mathematischen Seminar der Universität Hamburg
ABI Technik (German)
Academic Medicine
Academic Pediatrics
Academic Psychiatry
Academic Questions
Academy of Management Discoveries
Academy of Management Journal
Academy of Management Learning and Education
Academy of Management Perspectives
Academy of Management Proceedings
Academy of Management Review
Østergaard, Lauge; Smerup, Morten Holdgaard; Iversen, Kasper; Jensen, Andreas Dalsgaard; Dahl, Anders; Chamat-Hedemand, Sandra; et al. (2020). Differences in mortality in patients undergoing surgery for infective endocarditis according to age and valvular surgery. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.5134163.v1
or
Select your citation style and then place your mouse over the citation text to select it.
SHARE
Usage metrics
Read the peer-reviewed publication
AUTHORS (12)
LØ
Lauge Østergaard
MS
Morten Holdgaard Smerup
KI
Kasper Iversen
AJ
Andreas Dalsgaard Jensen
AD
Anders Dahl
SC
Sandra Chamat-Hedemand
NB
Niels Eske Bruun
JB
Jawad Haider Butt
HB
Henning Bundgaard
CT
Christian Torp-Pedersen
LK
Lars Køber
EF
Emil Fosbøl