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Surgical Procedure Time and Mortality in Patients with Infective Endocarditis Caused by Staphylococcus aureus or Streptococcus Species

Staphylococcus aureus (SA) and Streptococcus species (SS) show different clinical manifestations in infective endocarditis (IE), but the impact on the complexity of surgical treatment remains unclear. All patients with surgically treated IE due to SA or SS between July 2013 and December 2016 were ex...

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Autores principales: Paul, Gregor, Ochs, Laurin, Hohmann, Christopher, Baldus, Stephan, Michels, Guido, Meyer-Schwickerath, Charlotte, Fätkenheuer, Gerd, Mader, Navid, Wahlers, Thorsten, Weber, Carolyn, Jung, Norma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9104614/
https://www.ncbi.nlm.nih.gov/pubmed/35566663
http://dx.doi.org/10.3390/jcm11092538
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author Paul, Gregor
Ochs, Laurin
Hohmann, Christopher
Baldus, Stephan
Michels, Guido
Meyer-Schwickerath, Charlotte
Fätkenheuer, Gerd
Mader, Navid
Wahlers, Thorsten
Weber, Carolyn
Jung, Norma
author_facet Paul, Gregor
Ochs, Laurin
Hohmann, Christopher
Baldus, Stephan
Michels, Guido
Meyer-Schwickerath, Charlotte
Fätkenheuer, Gerd
Mader, Navid
Wahlers, Thorsten
Weber, Carolyn
Jung, Norma
author_sort Paul, Gregor
collection PubMed
description Staphylococcus aureus (SA) and Streptococcus species (SS) show different clinical manifestations in infective endocarditis (IE), but the impact on the complexity of surgical treatment remains unclear. All patients with surgically treated IE due to SA or SS between July 2013 and December 2016 were extracted from a prospectively collected, single-center registry. Data on patient characteristics, surgical procedures, and postprocedural outcomes were collected. SA-IE was more common with prosthetic valves (26.3% vs. 7.3%, p = 0.04), cardiac devices (14.3% vs. 0%, p = 0.03), previous cardiac surgery (28.6% vs. 9.8%, p = 0.03), intravenous drug abuse (14.3% vs. 0%, p = 0.03), and embolic events (57.1% vs. 26.8%, p = 0.007). Preoperative CRP was significantly higher in SA-IE (median 96.1 mg/L vs. 42.4 mg/L, p = 0.002). Otherwise, SS-IE affected more cusps/leaflets (mean 2.4 vs. 1.8, p = 0.03) and led to more valve dysfunction (83.8% vs. 54.3%, p = 0.007). Surgery times did not differ between the groups, though patients with SA spent more time in the intensive care unit (median 7 vs. 4.5 days, p = 0.04). Hospital mortality did not differ, but patients with SA-IE had unfavorable long-term survival (p = 0.001). Future studies need to be larger and focus on the mechanism behind the reduced long-term survival to mitigate the deleterious effect of SA in surgically treated patients with IE.
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spelling pubmed-91046142022-05-14 Surgical Procedure Time and Mortality in Patients with Infective Endocarditis Caused by Staphylococcus aureus or Streptococcus Species Paul, Gregor Ochs, Laurin Hohmann, Christopher Baldus, Stephan Michels, Guido Meyer-Schwickerath, Charlotte Fätkenheuer, Gerd Mader, Navid Wahlers, Thorsten Weber, Carolyn Jung, Norma J Clin Med Article Staphylococcus aureus (SA) and Streptococcus species (SS) show different clinical manifestations in infective endocarditis (IE), but the impact on the complexity of surgical treatment remains unclear. All patients with surgically treated IE due to SA or SS between July 2013 and December 2016 were extracted from a prospectively collected, single-center registry. Data on patient characteristics, surgical procedures, and postprocedural outcomes were collected. SA-IE was more common with prosthetic valves (26.3% vs. 7.3%, p = 0.04), cardiac devices (14.3% vs. 0%, p = 0.03), previous cardiac surgery (28.6% vs. 9.8%, p = 0.03), intravenous drug abuse (14.3% vs. 0%, p = 0.03), and embolic events (57.1% vs. 26.8%, p = 0.007). Preoperative CRP was significantly higher in SA-IE (median 96.1 mg/L vs. 42.4 mg/L, p = 0.002). Otherwise, SS-IE affected more cusps/leaflets (mean 2.4 vs. 1.8, p = 0.03) and led to more valve dysfunction (83.8% vs. 54.3%, p = 0.007). Surgery times did not differ between the groups, though patients with SA spent more time in the intensive care unit (median 7 vs. 4.5 days, p = 0.04). Hospital mortality did not differ, but patients with SA-IE had unfavorable long-term survival (p = 0.001). Future studies need to be larger and focus on the mechanism behind the reduced long-term survival to mitigate the deleterious effect of SA in surgically treated patients with IE. MDPI 2022-04-30 /pmc/articles/PMC9104614/ /pubmed/35566663 http://dx.doi.org/10.3390/jcm11092538 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Paul, Gregor
Ochs, Laurin
Hohmann, Christopher
Baldus, Stephan
Michels, Guido
Meyer-Schwickerath, Charlotte
Fätkenheuer, Gerd
Mader, Navid
Wahlers, Thorsten
Weber, Carolyn
Jung, Norma
Surgical Procedure Time and Mortality in Patients with Infective Endocarditis Caused by Staphylococcus aureus or Streptococcus Species
title Surgical Procedure Time and Mortality in Patients with Infective Endocarditis Caused by Staphylococcus aureus or Streptococcus Species
title_full Surgical Procedure Time and Mortality in Patients with Infective Endocarditis Caused by Staphylococcus aureus or Streptococcus Species
title_fullStr Surgical Procedure Time and Mortality in Patients with Infective Endocarditis Caused by Staphylococcus aureus or Streptococcus Species
title_full_unstemmed Surgical Procedure Time and Mortality in Patients with Infective Endocarditis Caused by Staphylococcus aureus or Streptococcus Species
title_short Surgical Procedure Time and Mortality in Patients with Infective Endocarditis Caused by Staphylococcus aureus or Streptococcus Species
title_sort surgical procedure time and mortality in patients with infective endocarditis caused by staphylococcus aureus or streptococcus species
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9104614/
https://www.ncbi.nlm.nih.gov/pubmed/35566663
http://dx.doi.org/10.3390/jcm11092538
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