TY - JOUR T1 - Long-term prognosis after surgery for infective endocarditis: Distinction between predictors of early and late survival JO - Enfermedades Infecciosas y Microbiología Clínica T2 - AU - Varela Barca,Laura AU - López-Menéndez,Jose AU - Navas Elorza,Enrique AU - Moya Mur,Jose Luis AU - Centella Hernéndez,Tomasa AU - Redondo Palacios,Ana AU - Fajardo,Edmundo Ricardo AU - Miguelena Hycka,Javier AU - Martín García,Miren AU - Muñoz Pérez,Rafael AU - Rodríguez-Roda Stuart,Jorge SN - 0213005X M3 - 10.1016/j.eimc.2018.10.017 DO - 10.1016/j.eimc.2018.10.017 UR - https://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-long-term-prognosis-after-surgery-for-S0213005X1830301X AB - ObjectivesCardiac surgery is a life-saving procedure in patients diagnosed with infective endocarditis (IE). There are several validated risk scores developed to predict early-mortality; nevertheless, long-term survival has been less investigated. The aim of the present study is to analyze the impact of IE-specific risk factors for early and long-term mortality. MethodsAn observational retrospective study was conducted that included all patients who underwent surgery for IE from 2002 to 2016. Median follow-up time after surgery was 53.2 months (IQI 26.2–106.8 months). In-hospital mortality was analyzed using multiple logistic regression. Long-term survival was analyzed after one, two and five years. Cox proportional hazards regression was employed to identify risk factors related to long-term mortality. ResultsOf the 180 patients underwent cardiac surgery, 133 were discharged alive (in-hospital mortality was 26.11%). 6 variables were identified as independent factors associated with in-hospital mortality, most of them closely related to the severity of IE: age, multivalvular involvement, critical preoperative status, preoperative mechanical ventilation, abscess and thrombocytopenia.Long-term survival in patients discharged alive was 89.1%, 87.4% and 77.6% after one, two and five years. Long-term mortality was independent of specific IE factors and 86.51% of deaths were not related to cardiovascular or infectious diseases. ConclusionDespite the high perioperative mortality rate after surgical treatment for active IE, long-term survival after hospital discharge was acceptable, regardless of the severity of the endocarditis episode. Although in-hospital survival depended mainly on several IE factors, long-term survival was not related to the severity of endocarditis baseline affection. ER -