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
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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Prognostic factors of mortality after surgery in infective endocarditis: systematic review and meta-analysis
Autoren:
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
DOI
https://doi.org/10.1007/s15010-019-01338-x
Verlag
Springer Berlin Heidelberg
Zeitschrift
Infection
A Journal of Infectious Diseases
Ausgabe 6/2019
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
Sie können e.Med Innere Medizin 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.
Sie können e.Med Allgemeinmedizin 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.
