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Erschienen in: Clinical Research in Cardiology 10/2016

27.04.2016 | Original Paper

Pre-operative stroke and neurological disability do not independently affect short- and long-term mortality in infective endocarditis patients

verfasst von: Mahmoud Diab, Albrecht Guenther, Christoph Sponholz, Thomas Lehmann, Gloria Faerber, Anna Matz, Marcus Franz, Otto W. Witte, Mathias W. Pletz, Torsten Doenst

Erschienen in: Clinical Research in Cardiology | Ausgabe 10/2016

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Abstract

Background

Infective endocarditis (IE) is still associated with high morbidity and mortality. The impact of pre-operative stroke on mortality and long-term survival is controversial. In addition, data on the severity of neurological disability due to pre-operative stroke are scarce. We analysed the impact of pre-operative stroke and the severity of its related neurological disability on short- and long-term outcome.

Methods

We retrospectively reviewed our data from patients operated for left-sided IE between 01/2007 and 04/2013. We performed univariate (Chi-Square and independent samples t test) and multivariate analyses.

Results

Among 308 consecutive patients who underwent cardiac surgery for left-sided IE, pre-operative stroke was present in 87 (28.2 %) patients. Patients with pre-operative stroke had a higher pre-operative risk profile than patient without it: higher Charlson comorbidity index (8.1 ± 2.6 vs. 6.6 ± 3.3) and higher incidence of Staphylococcus aureus infection (43 vs. 17 %) and septic shock (37 vs. 19 %). In-hospital mortality was equal but 5-year survival was significantly worse with pre-operative stroke (33.1 % vs. 45 %, p = 0.006). 5-year survival was worst in patients with severe neurological disability compared to mild disability (19.0 vs. 0.58 %, p = 0.002). However, neither pre-operative stroke nor the degree of neurological disability appeared as an independent risk factor for short or long-term mortality by multivariate analysis.

Conclusions

Pre-operative stroke and the severity of neurological disability do not independently affect short- and long-term mortality in patients with infective endocarditis. It appears that patients with pre-operative stroke present with a generally higher risk profile. This information may substantially affect decision-making.
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Metadaten
Titel
Pre-operative stroke and neurological disability do not independently affect short- and long-term mortality in infective endocarditis patients
verfasst von
Mahmoud Diab
Albrecht Guenther
Christoph Sponholz
Thomas Lehmann
Gloria Faerber
Anna Matz
Marcus Franz
Otto W. Witte
Mathias W. Pletz
Torsten Doenst
Publikationsdatum
27.04.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Research in Cardiology / Ausgabe 10/2016
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-016-0993-x

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