Long-Term Outcome of Active Infective Endocarditis with Renal Insufficiency in Cardiac Surgery
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- Tamura Kiyoshi
- Department of Cardiovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan Department of Cardiovascular Surgery, Musashino Red Cross Hospital, Tokyo, Japan
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- Arai Hirokuni
- Department of Cardiovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan
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- Yoshizaki Tomoya
- Department of Cardiovascular Surgery, Musashino Red Cross Hospital, Tokyo, Japan
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Background: The relation between infective endocarditis (IE) and renal insufficiency is uncertain. The aim of this study was to investigate active IE with renal insufficiency in cardiac surgery. <br>Patients and Methods: A retrospective record review was conducted of all cases with IE from January 1998 to July 2009. We identified 38 patients who had undergone surgical intervention (25 males and 13 females, mean age 57.3 ± 15.2 years, range 23–83 years) of IE as defined by the modified Duke criteria. Indications for surgical intervention included new, severe valvular regurgitation with heart failure, intracardiac abscesses, and recurrent embolic events. All patients were divided two groups; one group comprised patients without renal insufficiency (group N, n = 28), the other, those with renal insufficiency (group R, n = 10).<br>Results: Mean age of patients in group R was larger than that in of group N (66.3 ± 10.6 vs. 54.1 ± 15.4 years, p = 0.0268), and mean hemoglobin in group R than in group N (8.4 ± 0.9 vs. 10.3 ± 2.5 g/dl, p = 0.0215). In the early outcome, hospital death was greater in group R than in group N (20.0% vs. 0.0%, p = 0.0143). The 8-year survival was significantly worse in group R than in group N (50.0% vs. 96.4%, log rank test: p = 0.0042). Moreover, the 8-year actuarial freedom from cardiac events was significantly worse in group R than in group N (0.0% vs. 60.3%, log rank test: p = 0.0003), too. Renal insufficiency predicted an increase in long-term mortality (OR 12.104, 95%CI 1.349–108.641, p = 0.0259) and morbidity (OR 10.540, 95%CI 2.173–51.129, p = 0.0035).<br>Conclusions: In IE, renal insufficiency may allow for risk stratification of patients undergoing surgical intervention.
収録刊行物
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- Annals of Thoracic and Cardiovascular Surgery
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Annals of Thoracic and Cardiovascular Surgery 18 (3), 216-221, 2012
Annals of Thoracic and Cardiovascular Surgery 編集委員会
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詳細情報 詳細情報について
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- CRID
- 1390001204727690112
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- NII論文ID
- 10030789549
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- NII書誌ID
- AA11035352
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- COI
- 1:STN:280:DC%2BC38jps1GrsA%3D%3D
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- ISSN
- 21861005
- 13411098
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- PubMed
- 22790993
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- Crossref
- PubMed
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可