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Healthcare-Associated Infective Endocarditis—Surgical Perspectives

Health-care-associated infective endocarditis (HCA-IE), a disease with a poor prognosis, has become increasingly important. As surgical treatment is frequently required, this review aims to outline surgical perspectives on HCA-IE. We searched PubMed to identify publications from January 1980 to Marc...

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Autores principales: Musci, Tatjana, Grubitzsch, Herko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9457102/
https://www.ncbi.nlm.nih.gov/pubmed/36078887
http://dx.doi.org/10.3390/jcm11174957
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author Musci, Tatjana
Grubitzsch, Herko
author_facet Musci, Tatjana
Grubitzsch, Herko
author_sort Musci, Tatjana
collection PubMed
description Health-care-associated infective endocarditis (HCA-IE), a disease with a poor prognosis, has become increasingly important. As surgical treatment is frequently required, this review aims to outline surgical perspectives on HCA-IE. We searched PubMed to identify publications from January 1980 to March 2022. Reports were evaluated by the authors against a priori inclusion/exclusion criteria. Studies reporting on surgical treatment of HCA-IE including outcome were selected. Currently, HCA-IE accounts for up to 47% of IE cases. Advanced age, cardiac implants, and comorbidity are important predispositions, and intravascular catheters or frequent vascular access are significant sources of infection. Staphylococci and enterococci are the leading causative microorganisms. Surgery, although frequently indicated, is rejected in 24–69% because of prohibitive risk. In-hospital mortality is significant after surgery (29–50%) but highest in patients rejected for operation (52–83%). Furthermore, the length of hospital stay is prolonged. With aging populations, age-dependent morbidity, increasing use of cardiac implants, and growing healthcare utilization, HCA-IE is anticipated to gain further importance. A better understanding of pathogenesis, clinical profile, and outcomes is paramount. Further research on surgical treatment is needed to provide more comprehensive information for defining the most suitable treatment option, finding the optimal time for surgery, and reducing morbidity and mortality.
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spelling pubmed-94571022022-09-09 Healthcare-Associated Infective Endocarditis—Surgical Perspectives Musci, Tatjana Grubitzsch, Herko J Clin Med Review Health-care-associated infective endocarditis (HCA-IE), a disease with a poor prognosis, has become increasingly important. As surgical treatment is frequently required, this review aims to outline surgical perspectives on HCA-IE. We searched PubMed to identify publications from January 1980 to March 2022. Reports were evaluated by the authors against a priori inclusion/exclusion criteria. Studies reporting on surgical treatment of HCA-IE including outcome were selected. Currently, HCA-IE accounts for up to 47% of IE cases. Advanced age, cardiac implants, and comorbidity are important predispositions, and intravascular catheters or frequent vascular access are significant sources of infection. Staphylococci and enterococci are the leading causative microorganisms. Surgery, although frequently indicated, is rejected in 24–69% because of prohibitive risk. In-hospital mortality is significant after surgery (29–50%) but highest in patients rejected for operation (52–83%). Furthermore, the length of hospital stay is prolonged. With aging populations, age-dependent morbidity, increasing use of cardiac implants, and growing healthcare utilization, HCA-IE is anticipated to gain further importance. A better understanding of pathogenesis, clinical profile, and outcomes is paramount. Further research on surgical treatment is needed to provide more comprehensive information for defining the most suitable treatment option, finding the optimal time for surgery, and reducing morbidity and mortality. MDPI 2022-08-24 /pmc/articles/PMC9457102/ /pubmed/36078887 http://dx.doi.org/10.3390/jcm11174957 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 Review
Musci, Tatjana
Grubitzsch, Herko
Healthcare-Associated Infective Endocarditis—Surgical Perspectives
title Healthcare-Associated Infective Endocarditis—Surgical Perspectives
title_full Healthcare-Associated Infective Endocarditis—Surgical Perspectives
title_fullStr Healthcare-Associated Infective Endocarditis—Surgical Perspectives
title_full_unstemmed Healthcare-Associated Infective Endocarditis—Surgical Perspectives
title_short Healthcare-Associated Infective Endocarditis—Surgical Perspectives
title_sort healthcare-associated infective endocarditis—surgical perspectives
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9457102/
https://www.ncbi.nlm.nih.gov/pubmed/36078887
http://dx.doi.org/10.3390/jcm11174957
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