Outcomes of Early Surgery for Infective Endocarditis
Keywords:Infective endocarditis, surgical outcome
Background: There is no evidence regarding the optimal timing for surgery for infective endocarditis. The decision to perform surgery mostly depends on the surgeon’s opinion. The authors conducted this study to compare the outcomes of patients who underwent surgery within 14 days after established diagnosis and those who underwent surgery later than 14 days.
Methods: The authors retrospectively collected the data of patients who were diagnosed with definitive and possible infective endocarditis from 31 January 2008 to 1 May 2015. There were 170 patients. Surgery was performed in 110 patients. The outcomes of surgery between the patient groups whose surgery was performed within 14 days (early surgery group) and later (late surgery group) were compared.
Results: There were 110 patients who underwent surgery. There were 16 deaths in this group (14.5%). There were 60 patients who underwent medical treatment alone. In this group, there were 18 deaths (30%). The mortality rates in the early surgery group and the late surgery group were 17.4% and 10%, respectively, so the mortality in the early surgery group was higher with the odds ratio of 3.85. Nevertheless, the difference was not statistically significant (OR = 3.85, 95% CI: 0.58 - 25.6). The complications after surgery, length of ICU stay, and length of hospital stay were similar. However, the authors found that EuroSCORE and size of vegetation were statistically higher in the early surgery group.
Conclusion: Comparing the mortality rate of infective endocarditis, the authors found that the mortality rate in the early surgery group was higher than the late surgery group. However, the difference was not statistically significant.
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