2026-04-27T19:54:50Zhttps://uvadoc.uva.es/oai/request
oai:uvadoc.uva.es:10324/701982024-10-01T12:29:17Zcom_10324_1179com_10324_931com_10324_894col_10324_1306
UVaDOC author Miguel, María de author López Díaz, Javier author Vilacosta, Isidre author Olmos, Carmen author Sáez, Carmen author Cabezón, Gonzalo author Zulet, Pablo author Jerónimo, Adrián author Gómez, Daniel author Pulido, Paloma author Lozano, Adrián author Oña, Andrea author Gómez Salvador, Itziar author San Román Calvar, José Alberto 2024-09-26T07:34:48Z 2024-09-26T07:34:48Z 2024 Microorganisms, 2024, Vol. 12, Nº. 3, 607 2076-2607 https://uvadoc.uva.es/handle/10324/70198 10.3390/microorganisms12030607 607 3 Microorganisms 12 2076-2607 Approximately a quarter of patients with infective endocarditis (IE) who have surgical indication only receive antibiotic treatment. Their short-term prognosis is dismal. We aimed to describe the characteristics of this group of patients to evaluate the mortality according to the cause of rejection and type of surgical indication and to analyze their prognostic factors of mortality. From 2005 to 2022, 1105 patients with definite left-sided IE were consecutively attended in three tertiary hospitals. Of them, 912 (82.5%) had formal surgical indication according to the most recent European Guidelines available in each period of the study and 303 (33%) only received medical treatment. These were older, had more comorbidities and higher in-hospital (46% vs. 24%; p < 0.001) and one year mortality (57.1% vs. 27.6%; p < 0.001) than operated patients. The main reason for surgical rejection was high surgical risk (57.1%) and the highest mortality when the cause were severe neurological conditions (76%). When the endocarditis team took the decision not to operate (25.5% of the patients), in-hospital (7%) and one-year mortality (17%) were low. In-hospital mortality associated with each surgical indication was 67% in heart failure, 53% in uncontrolled infection and 45% in prevention of embolisms (p < 0.001). Heart failure (OR: 2.26 CI95%: 1.29–3.96; p = 0.005), Staphylococcus aureus (OR: 3.17; CI95%: 1.72–5.86; p < 0.001) and persistent infection (OR: 5.07 CI95%: 2.85–9.03) are the independent risk factors of in-hospital mortality. One third of the patients with left-sided IE and formal surgical indication are rejected for surgery. In-hospital mortality is very high, especially when heart failure is the indication for surgery and when severe neurological conditions the reason for rejection. Short term prognosis of patients rejected by a specialized endocarditis team is favorable. eng Atribución 4.0 Internacional Endocarditis Cardiovascular system - Diseases Cardiovascular, Aparato - Enfermedades Cardiology Surgery Mortality Mortalidad Microbiology Medicine Public health Clinical profile and prognosis of patients with left-sided infective endocarditis with surgical indication who are not operated info:eu-repo/semantics/article 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URL https://uvadoc.uva.es/bitstream/10324/70198/1/Clinical-Profile-and-Prognosis.pdf File MD5 496109e649fc2873a0861fa15d95b492 1503209 application/pdf Clinical-Profile-and-Prognosis.pdf