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https://doi.org/10.1016/j.jinf.2015.09.005
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Título: | Left-sided infective endocarditis in patients with liver cirrhosis |
Fecha de publicación: | 25-sep-2015 |
Editorial: | Elsevier |
Cita bibliográfica: | Journal of Infection. 2015, 71(6): 627-641 |
ISSN: | Print: 0163-4453 Electronic: 1532-2742 |
Palabras clave: | Liver cirrhosis Left-sided infectious endocarditis Risk stratification Prognostic Surgery |
Resumen: | 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 ChildePugh 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: 1.23e1.85; p < 0.001). However, patients in stage A had similar mortality to patients without cirrhosis (31.8% vs. 28.4% p Z 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 |
Autor/es principal/es: | Ruiz-Morales, J. Ivanova-Georgieva, R. Fernández-Hidalgo, N. García-Cabrera, E. Miró, Jose M. Muñoz, P. Almirante, B. Plata-Ciézar, A. González-Ramallo, V. Gálvez-Acebal, J. Fariñas, M.C. Bravo-Ferrer, J.M. Goenaga-Sánchez, M.A. Hidalgo-Tenorio, C. Goikoetxea-Agirre, J. Alarcón-González, A. de García-Vázquez, Elisa Endocarditis Group-Grupo de Apoyo al Manejo de la Endocarditis en España (GAMES) Spanish Network for Research in Infectious Diseases (REIPI) |
Facultad/Departamentos/Servicios: | Facultades, Departamentos, Servicios y Escuelas::Departamentos de la UMU::Medicina Interna |
Versión del editor: | https://www.sciencedirect.com/science/article/pii/S0163445315002832?via%3Dihub |
URI: | http://hdl.handle.net/10201/142704 |
DOI: | https://doi.org/10.1016/j.jinf.2015.09.005 |
Tipo de documento: | info:eu-repo/semantics/article |
Número páginas / Extensión: | 15 |
Derechos: | info:eu-repo/semantics/embargoedAccess |
Descripción: | ©2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved. This document is the Published, version of a Published Work that appeared in final form in Journal of Infection. To access the final edited and published work see https://doi.org/10.1016/j.jinf.2015.09.005 |
Aparece en las colecciones: | Artículos: Medicina |
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