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Left-sided infective endocarditis in patients with liver cirrhosis

2015; Elsevier BV; Volume: 71; Issue: 6 Linguagem: Inglês

10.1016/j.jinf.2015.09.005

1532-2742

Josefa Ruiz‐Morales, Rada Ivanova–Georgieva, Núria Fernández-Hidalgo, Emilio García-Cabrera, José M. Miró, Patricia Muñóz, Benito Almirante, Antonio Plata, Víctor José González Ramallo, Juan Gálvez-Acebal, María Carmen Fariñas, José María Bravo-Ferrer, Miguel Á. Goenaga-Sánchez, Carmen Hidalgo-Tenorio, Josune Goikoetxea, A. de Alarcón-González, Fernando Fernández Sánchez, M. Noureddine, Gabriel Rosas, Javier de la Torre, José I. Aramendi, Elena Bereciartúa, María Victoria Boado, Marta Campaña Lázaro, J.J. Goiti, José L. Hernández, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Pedro María Pérez, Regino Rodríguez, Roberto Voces, Ma Victoria García López, Manuel Márquez, Isabel Rodríguez Bailón, Gemma Sánchez Espín, Juan C. Otero, Ana María Cuende, Eduardo Gaminde, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Carlos Reviejo, Tomás Echeverría, Eduardo Gaminde, Ana María de Caso Fuertes, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, María del Mar Carmona, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Míguez Rey, María Rodríguez Mayo, Dolores Sousa, Ma Carmen Zúñiga, Francisco Javier Martı́nez-Marcos, Joaquin Cabezas, M.M. Alonso, Beatriz Castro, Dácil García Marrero, Ma del Carmen Durán, Ma Antonia Miguel Gómez, Juan La Calzada, Ibrahim Nassar, José Ma Reguera Iglesias, Víctor Asensi, Carlos Costas, Jesús de la Hera, Jonathan Fernández-Suarez, José Manuel García Ruiz, Lisardo Iglesias Fraile, José López Menéndez, Pilar Mencía Bajo, Carlos Montilla, Alfonso Moreno Torrico, Carmen Palomo, B. Martínez, Ángeles Rodríguez, Raquel Rodríguez-García, Mauricio Telenti, Manuel Almela, Yolanda Armero, Manuel Azqueta, Ximena Castañeda, Carlos Cervera, Carlos Falces, C. García-de-la-Mària, José M. Gatell, Jaume Llopis, Francesc Marco, Carlos A. Mestres, Asunción Moreno, Salvador Pié i Ninot, J. M. Ramírez, Marta Sitges, Carlos Paré, Juan M. Pericàs, Javier Bermejo, Emilio Bouza, Viviana de Egea, Alia Eworo, Ana Fernández‐Cruz, Ma Eugenia García Leoni, Marcela González del Vecchio, Víctor José González Ramallo, Martha Kestler Hernández, Mercedes Marín, Manuel Martínez‐Sellés, Ma Cruz Menárguez, Hugo Rodríguez-Abella, Marta Rodríguez‐Créixems, J. Roda, Blanca Pinilla, Ángel González Pinto, Maricela Valerio, Eduardo Verde Moreno, Isabel Antorrena, Mar Moreno, José Ramón Paño, Sandra Rosillo, María Romero, Araceli Saldaña, Carlos Armiñanzas Castillo, Ana Arnáiz, José R. Berrazueta, Sara Bellisco, Manuel Cobo Belaustegui, Raquel Durán, Concepción Fariñas-Álvarez, Carlos Fernández Mazarrasa, Rubén Gómez Izquierdo, Claudia González-Rico, José Gutiérrez Díez, Rafael Martín Durán, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Pablo García Pavía, Jesús Santos González, Beatriz Orden, António Ramos, Elena Rodríguez‐González, Tomasa Centella, José Ramón Fernández Hermida, José Luis Betrán Moya, Pilar Martínez, Enrique Navas, Enrique Oliva, Alejandro del Río, Soledad Ruíz, Antonio de Castro, Marina de Cueto, Pastora Gallego, Jesús Rodríguez‐Baño, José Antonio Lepe, Rafael Luque Márquez, Encarnación Gutiérrez‐Carretero, J Galan, Luis Javier Alonso, José Manuel Azcona, José Ramón Blanco, Lara García-Álvarez, José A. Oteo, Natividad Benito, Mercè Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, Mar Álvarez, Ángel L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E Tijeira, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, Ma Belén Nacle, Antonio Sánchez-Porto, Luis Vallejo, José María Arribas, Elisa García Vázquez, Alicia Hernández Torres, Joaquín Ruiz Gómez, Gonzalo de la Morena, Ángel Cabo Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, Ma Antonia Sepúlveda, Eva Cascales Alcolea, Pilar Egea Serrano, Jose Roca,

Ultrasound in Clinical Applications

Summary Objective To evaluate the course of left-sided infective endocarditis (LsIE) in patients with liver cirrhosis (LC) analyzing its influence on mortality and the impact of surgery. Methods Prospective cohort study, conducted from 1984 to 2013 in 26 Spanish hospitals. Results A total of 3.136 patients with LsIE were enrolled and 308 had LC: 151 Child–Pugh A, 103 B, 34 C and 20 were excluded because of unknown stage. Mortality was significantly higher in the patients with LsIE and LC (42.5% vs. 28.4%; p < 0.01) and this condition was in general an independent worse factor for outcome (HR 1.51, 95% CI: 1.23–1.85; p < 0.001). However, patients in stage A had similar mortality to patients without cirrhosis (31.8% vs. 28.4% p = NS) and in this stage heart surgery had a protective effect (28% in operated patients vs. 60% in non-operated when it was indicated). Mortality was significantly higher in stages B (52.4%) and C (52.9%) and the prognosis was better for patients in stage B who underwent surgery immediately (mortality 50%) compared to those where surgery was delayed (58%) or not performed (74%). Only one patient in stage C underwent surgery. Conclusions Patients with liver cirrhosis and infective endocarditis have a poorer prognosis only in stages B and C. Early surgery must be performed in stages A and although in selected patients in stage B when indicated.