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Long‐Term Outcome of Infective Endocarditis: The Impact of Early Surgical Intervention

2001; Oxford University Press; Volume: 33; Issue: 10 Linguagem: Inglês

10.1086/323785

1537-6591

Jihad Bishara, Leonard Leibovici, Dina Gartman‐Israel, Alex Sagie, Arkadi Kazakov, Eugeni Miroshnik, Shai Ashkenazi, Silvio Pitlik,

Cardiac Valve Diseases and Treatments

To determine the impact of early surgical intervention on long-term survival in patients with infective endocarditis (IE), charts of all patients who had IE from January 1987 through December 1996 were reviewed. A total of 252 patients with definite or possible IE were included. Forty-four patients (17.5%) had early surgery on median hospital day 2 (range, 0-30 days), and 208 patients (82.5%) received medical treatment alone. On multivariate analysis, several variables, including early surgical intervention, improved long-term survival rates (hazard ratio, 1.5; P=.03), mainly in patients with Staphylococcus aureus etiology (P=.04). When patients with prosthetic devices were excluded, the median duration of survival for patients who had early surgery was >150 months, compared with 61.5 months for patients in the medical group (P=.1). Early surgical intervention compared with medical therapy alone is associated with increased short- and long-term survival rates in patients with IE, primarily when IE is caused by S. aureus.