Sikander Tajik Nielsen, Jeppe K Petersen, Katra Hadji-Turdeghal, Peter Laursen Graversen, Morten Holdgaard Smerup, Lauge Østergaard, Lars Koeber, Emil Loldrup Fosbøl
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All-cause mortality was assessed at 5 and 10 years using the Kaplan-Meier estimator and the multivariate Cox model. Further, we examined the time spent in hospital during the first year following the index date.</p><p><strong>Results: </strong>We identified 1050 patients (77.5% male, median age 65.8 years) surgically treated for IE and 3150 controls. The most common pathogens were: Viridans group streptococci (44.6%), <i>Staphylococcus aureus</i> (23.1%), Enterococci (17.9%). Patients with IE had higher absolute 5-year (20.1% vs 12.9%, p=0.001) and 10-year (38.5% vs 27.9%, p<0.001) mortality compared with controls. Adjusted 5-year and 10-year mortality rates were also higher in patients with IE (5-year HR=1.49 (95% CI 1.24 to 1.79) and 10-year HR 1.38 (95% CI 1.19 to 1.60)). Patients with IE experienced more frequent and longer hospitalisations within the first year postsurgery, as 36.8% patients with IE were hospitalised within the first year following index compared with 17.5% in the matched controls. 9.3% of patients with IE were hospitalised for >14 days compared with 3.0% in matched controls. 60 patients with IE (5.7%) died within the first year following index compared with 51 (1.6%) in the matched controls.</p><p><strong>Conclusion: </strong>Patients with IE who underwent valve surgery had a higher crude mortality than their controls from the background population. 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Patients with IE experienced more frequent and longer hospitalisations within the first year postsurgery, as 36.8% patients with IE were hospitalised within the first year following index compared with 17.5% in the matched controls. 9.3% of patients with IE were hospitalised for >14 days compared with 3.0% in matched controls. 60 patients with IE (5.7%) died within the first year following index compared with 51 (1.6%) in the matched controls.</p><p><strong>Conclusion: </strong>Patients with IE who underwent valve surgery had a higher crude mortality than their controls from the background population. 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引用次数: 0
摘要
背景：感染性心内膜炎（IE）的瓣膜手术可以提高生存率，但风险很大。与背景人群相比，手术存活患者的长期预后数据有限。我们的目的是比较在瓣膜手术后存活90天的IE患者与匹配的丹麦背景人群的长期死亡率和发病率。方法：使用丹麦的登记处，我们确定了2010-2023年首次进行IE手术后存活bbb90天的患者。每名患者按年龄、性别和选定的合并症与背景人群中的对照组进行1:3匹配。使用Kaplan-Meier估计器和多变量Cox模型评估5年和10年的全因死亡率。此外，我们检查了在索引日期后的第一年住院的时间。结果：我们确定了1050例手术治疗IE的患者（77.5%为男性，中位年龄65.8岁）和3150例对照。最常见的病原菌为：翠绿菌群链球菌（44.6%）、金黄色葡萄球菌（23.1%）、肠球菌（17.9%）。IE患者的5年绝对生存率（20.1% vs 12.9%, p=0.001）和10年绝对生存率（38.5% vs 27.9%， p14天）高于匹配对照组的3.0%。60例IE患者（5.7%）在术后一年内死亡，而对照组为51例（1.6%）。结论：接受瓣膜手术的IE患者的粗死亡率高于背景人群中的对照组。在调整混杂因素后，IE患者群体的5年和10年死亡率仍然较高。
Long-term mortality in patients who survive surgery for infective endocarditis versus the background population: a nationwide study.
Background: Valvular surgery for infective endocarditis (IE) can improve survival but carries substantial risk. Limited data exist on long-term outcomes for patients who survive surgery compared with a background population. We aim to compare long-term mortality and morbidity in patients with IE, who survive 90-days following valvular surgery to a matched Danish background population.
Methods: Using Danish registries, we identified patients who survived >90 days post-valvular surgery for first-time IE (2010-2023). Each patient was matched 1:3 with controls from the background population by age, sex and selected comorbidities. All-cause mortality was assessed at 5 and 10 years using the Kaplan-Meier estimator and the multivariate Cox model. Further, we examined the time spent in hospital during the first year following the index date.
Results: We identified 1050 patients (77.5% male, median age 65.8 years) surgically treated for IE and 3150 controls. The most common pathogens were: Viridans group streptococci (44.6%), Staphylococcus aureus (23.1%), Enterococci (17.9%). Patients with IE had higher absolute 5-year (20.1% vs 12.9%, p=0.001) and 10-year (38.5% vs 27.9%, p<0.001) mortality compared with controls. Adjusted 5-year and 10-year mortality rates were also higher in patients with IE (5-year HR=1.49 (95% CI 1.24 to 1.79) and 10-year HR 1.38 (95% CI 1.19 to 1.60)). Patients with IE experienced more frequent and longer hospitalisations within the first year postsurgery, as 36.8% patients with IE were hospitalised within the first year following index compared with 17.5% in the matched controls. 9.3% of patients with IE were hospitalised for >14 days compared with 3.0% in matched controls. 60 patients with IE (5.7%) died within the first year following index compared with 51 (1.6%) in the matched controls.
Conclusion: Patients with IE who underwent valve surgery had a higher crude mortality than their controls from the background population. After adjusting for confounders, 5-year and 10-year mortality rates remained higher in the IE patient population.
期刊介绍：
Open Heart is an online-only, open access cardiology journal that aims to be “open” in many ways: open access (free access for all readers), open peer review (unblinded peer review) and open data (data sharing is encouraged). The goal is to ensure maximum transparency and maximum impact on research progress and patient care. The journal is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart aims to operate a fast submission and review process with continuous publication online, to ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer review process, and all articles go through a statistical assessment to ensure robustness of the analyses. Open Heart is an official journal of the British Cardiovascular Society.
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