Left-sided infectious endocarditis (LSIE) has a poor prognosis and surgery is required in more than half of the patients to improve survival. Our hypothesis was that clinical complications develop after prognosis for the impact of surgery.
Among 99 consecutive episodes of LSIE, 26 (26.3%) had heart surgery. Among them, 41 patients (6.3%) died on the same day of surgery, 112 (17.2%) died after the first day of surgery during their hospital stay and 500 (76.5%) were successfully unloaded. We compared the latter two groups and performed a multivariate analysis of hospital mortality.
Age (OR 1.02, 95% CI 1.01 to 1.04), perianular complications (OR 1.9, 95% CI 1.2 to 3.2), renal failure after surgery (OR 2, 4, 95% CI 1.3–4.4) but not before surgery, and septic shock after surgery (OR 9.6, 95% CI5.4–17.1), but not before surgery, do not predict death in hospital for LSIE patients who have undergone heart disease surgery.
A thorough clinical evaluation for prognostic purposes in infectious endocarditis after surgery is mandatory. Hospital mortality of patients with infectious endocarditis and operated depends mainly on clinical course after surgery.
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Publié par Elsevier Masson SAS.