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Infection
Erschienen in: Infection 6/2019

28.06.2019 | Review

Prognostic factors of mortality after surgery in infective endocarditis: systematic review and meta-analysis

verfasst von: Laura Varela Barca, Enrique Navas Elorza, Nuria Fernández-Hidalgo, Jose Luis Moya Mur, Alfonso Muriel García, B. M. Fernández-Felix, Javier Miguelena Hycka, Jorge Rodríguez-Roda, Jose López-Menéndez

Erschienen in: Infection | Ausgabe 6/2019

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Abstract

Purpose

There is a lack of consensus about which endocarditis-specific preoperative characteristics have an actual impact over postoperative mortality. Our objective was the identification and quantification of these factors.

Methods

We performed a systematic review of all the studies which reported factors related to in-hospital mortality after surgery for acute infective endocarditis, conducted according to PRISMA recommendations. A search string was constructed and applied on three different databases. Two investigators independently reviewed the retrieved references. Quality assessment was performed for identification of potential biases. All the variables that were included in at least two validated risk scores were meta-analyzed independently, and the pooled estimates were expressed as odds ratios (OR) with their confidence intervals (CI).

Results

The final sample consisted on 16 studies, comprising a total of 7484 patients. The overall pooled OR were statistically significant (p < 0.05) for: age (OR 1.03, 95% CI 1.00–1.05), female sex (OR 1.56, 95% CI 1.35–1.81), urgent or emergency surgery (OR 2.39 95% CI 1.91–3.00), previous cardiac surgery (OR 2.19, 95% CI 1.84–2.61), NYHA ≥ III (OR 1.84, 95% CI 1.33–2.55), cardiogenic shock (OR 4.15, 95% CI 3.06–5.64), prosthetic valve (OR 1.98, 95% CI 1.68–2.33), multivalvular affection (OR 1.35, 95% CI 1.01–1.82), renal failure (OR 2.57, 95% CI 2.15–3.06), paravalvular abscess (OR 2.39, 95% CI 1.77–3.22) and S. aureus infection (OR 2.27, 95% CI 1.89–2.73).

Conclusions

After a systematic review, we identified 11 preoperative factors related to an increased postoperative mortality. The meta-analysis of each of these factors showed a significant association with an increased in-hospital mortality after surgery for active infective endocarditis.

Graphic abstract

Graph summary of the Pooled Odds Ratios of the 11 preoperative factors analyzed after the systematic review and meta-analysis.
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Metadaten
Titel
Prognostic factors of mortality after surgery in infective endocarditis: systematic review and meta-analysis
verfasst von
Laura Varela Barca
Enrique Navas Elorza
Nuria Fernández-Hidalgo
Jose Luis Moya Mur
Alfonso Muriel García
B. M. Fernández-Felix
Javier Miguelena Hycka
Jorge Rodríguez-Roda
Jose López-Menéndez
Publikationsdatum
28.06.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Infection / Ausgabe 6/2019
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-019-01338-x

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