Dora Pestotnik Stres

Health Research (Bailrigg) | Year 2 | Degree: MBChB Medicine and Surgery

Effect of Timing of Surgery in Active Infective Endocarditis on Outcomes of Surgery in General Population and Subgroups of Patients with Preoperative Neurological Complications

Background: Infective endocarditis-(IE) is associated with high mortality. Optimal timing of surgical treatment is controversial, especially after preoperative neurological complications-(PNC).

Aim: Investigate the effects of timing of surgery on short and long-term outcomes in general population and in patients with PNC.

Methods: This single centre retrospective study consisted of 216 patients (38 with PNC) undergoing surgery for active IE from 1996-2021. Patients were divided into very-early~(≤2 days), early~(3-7 days) and late surgery~(8-42 days) groups and their preoperative risk factors assessed using EuroSCORE and its components. Outcomes were compared between groups and subgroups with PNC.

Results: Mean age of patients was 55.8 years, 77.3% were male. Effected valves were aortic-(53%) and mitral-(17%). Very-early group had statistically significant higher additive-(p=0.002) and logistic-(p=0.003) EuroSCOREs. No significant differences were found in EuroSCOREs between PNC subgroups-(p=0.815, p=0.547). ICU&postoperative stays, short and long-term (up to 10-years) mortalities didn’t differ significantly between groups or subgroups. 30-day-mortality ranged from 6.7%-12.3% (p=0.429) between groups, 10-year mortality from 21.0%-24.4% (p=0.886).

Conclusions: Timing of surgery in general population showed no apparent impact on outcomes following valve surgery for IE. Very-early surgery~(≤2 days) appears safe despite a higher risk profile. In presence of PNC, timing of surgery doesn’t seem to affect outcomes.

Dora Pestotnik Stres

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