Impact of Early Valve Surgery on Outcome of Staphylococcus aureus Prosthetic Valve Infective Endocarditis: Analysis in the International Collaboration of Endocarditis-Prospective Cohort Study. - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Clinical Infectious Diseases Année : 2015

Impact of Early Valve Surgery on Outcome of Staphylococcus aureus Prosthetic Valve Infective Endocarditis: Analysis in the International Collaboration of Endocarditis-Prospective Cohort Study.

François Alla
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Vance G Fowler
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Daniel J Sexton
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G Ralph Corey
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Andrew Wang
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Marie-Line Erpelding
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Nuria Fernández-Hidalgo
  • Fonction : Auteur
Efthymia Giannitsioti
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Bruno Hoen

Résumé

Background - The impact of early valve surgery (EVS) on the outcome of Staphylococcus aureus (SA) prosthetic valve infective endocarditis (PVIE) is unresolved. The objective of this study was to evaluate the association between EVS, performed within the first 60 days of hospitalization, and outcome of SA PVIE within the International Collaboration on Endocarditis-Prospective Cohort Study. Methods - Participants were enrolled between June 2000 and December 2006. Cox proportional hazards modeling that included surgery as a time-dependent covariate and propensity adjustment for likelihood to receive cardiac surgery was used to evaluate the impact of EVS and 1-year all-cause mortality on patients with definite left-sided S. aureus PVIE and no history of injection drug use. Results - EVS was performed in 74 of the 168 (44.3%) patients. One-year mortality was significantly higher among patients with S. aureus PVIE than in patients with non-S. aureus PVIE (48.2% vs 32.9%; P = .003). Staphylococcus aureus PVIE patients who underwent EVS had a significantly lower 1-year mortality rate (33.8% vs 59.1%; P = .001). In multivariate, propensity-adjusted models, EVS was not associated with 1-year mortality (risk ratio, 0.67 [95% confidence interval, .39-1.15]; P = .15). Conclusions - In this prospective, multinational cohort of patients with S. aureus PVIE, EVS was not associated with reduced 1-year mortality. The decision to pursue EVS should be individualized for each patient, based upon infection-specific characteristics rather than solely upon the microbiology of the infection causing PVIE.

Dates et versions

hal-01115453 , version 1 (11-02-2015)

Identifiants

Citer

Catherine Chirouze, François Alla, Vance G Fowler, Daniel J Sexton, G Ralph Corey, et al.. Impact of Early Valve Surgery on Outcome of Staphylococcus aureus Prosthetic Valve Infective Endocarditis: Analysis in the International Collaboration of Endocarditis-Prospective Cohort Study.. Clinical Infectious Diseases, 2015, 60 (5), pp.741-749. ⟨10.1093/cid/ciu871⟩. ⟨hal-01115453⟩
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