Role of age and comorbidities in mortality of patients with infective endocarditis

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015. Patients were stratified into three age groups:<65 years, 65 to 80 years, and = 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 = 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients =80 years who underwent surgery were significantly lower compared with other age groups (14.3%, 65 years; 20.5%, 65-79 years; 31.3%, =80 years). In-hospital mortality was lower in the <65-year group (20.3%, <65 years;30.1%, 65-79 years;34.7%, =80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%, =80 years; p = 0.003).Independent predictors of mortality were age = 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI = 3 (HR:1.62; 95% CI:1.39–1.88), and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared, the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. Conclusion: There were no differences in the clinical presentation of IE between the groups. Age = 80 years, high comorbidity (measured by CCI), and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

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Disk Evolution Study Through Imaging of Nearby Young Stars (DESTINYS): A close low-mass companion to ET Cha

Context. To understand the formation of planetary systems, it is important to understand the initial conditions of planet formation, that is, the young gas-rich planet forming disks. Spatially resolved, high-contrast observations are of particular interest since substructures in disks that are linked to planet formation can be detected. In addition, we have the opportunity to reveal close companions or even planets in formation that are embedded in the disk. Aims. In this study, we present the first results of the Disk Evolution Study Through Imaging of Nearby Young Stars (DESTINYS), an ESO/SPHERE large program that is aimed at studying disk evolution in scattered light, mainly focusing on a sample of low-mass stars (< 1 M⊙) in nearby (∼200 pc) star-forming regions. In this particular study, we present observations of the ET Cha (RECX 15) system, a nearby “old” classical T Tauri star (5−8 Myr, ∼100 pc), which is still strongly accreting. Methods. We used SPHERE/IRDIS in the H-band polarimetric imaging mode to obtain high spatial resolution and high-contrast images of the ET Cha system to search for scattered light from the circumstellar disk as well as thermal emission from close companions. We additionally employed VLT/NACO total intensity archival data of the system taken in 2003. Results. Here, we report the discovery, using SPHERE/IRDIS, of a low-mass (sub)stellar companion to the η Cha cluster member ET Cha. We estimate the mass of this new companion based on photometry. Depending on the system age, it is either a 5 Myr, 50 MJup brown dwarf or an 8 Myr, 0.10 M⊙ M-type, pre-main-sequence star. We explore possible orbital solutions and discuss the recent dynamic history of the system. Conclusions. Independent of the precise companion mass, we find that the presence of the companion likely explains the small size of the disk around ET Cha. The small separation of the binary pair indicates that the disk around the primary component is likely clearing from the outside in, which explains the high accretion rate of the system

Perturbers: SPHERE detection limits to planetary-mass companions in protoplanetary disks

The detection of a wide range of substructures such as rings, cavities, and spirals has become a common outcome of high spatial resolution imaging of protoplanetary disks, both in the near-infrared scattered light and in the thermal millimetre continuum emission. The most frequent interpretation of their origin is the presence of planetary-mass companions perturbing the gas and dust distribution in the disk (perturbers), but so far the only bona fide detection has been the two giant planets carving the disk around PDS 70. Here, we present a sample of 15 protoplanetary disks showing substructures in SPHERE scattered-light images and a homogeneous derivation of planet detection limits in these systems. To obtain mass limits we rely on different post-formation luminosity models based on distinct formation conditions, which are critical in the first million years of evolution. We also estimate the mass of these perturbers through a Hill radius prescription and a comparison to ALMA data. Assuming that one single planet carves each substructure in scattered light, we find that more massive perturbers are needed to create gaps within cavities than rings, and that we might be close to a detection in the cavities of RX J1604.3-2130A, RX J1615.3-3255, Sz Cha, HD 135344B, and HD 34282. We reach typical mass limits in these cavities of 3–10 MJup. For planets in the gaps between rings, we find that the detection limits of SPHERE high-contrast imaging are about an order of magnitude away in mass, and that the gaps of PDS 66 and HD 97048 seem to be the most promising structures for planet searches. The proposed presence of massive planets causing spiral features in HD 135344B and HD 36112 are also within SPHERE’s reach assuming hot-start models. These results suggest that the current detection limits are able to detect hot-start planets in cavities, under the assumption that they are formed by a single perturber located at the centre of the cavity. More realistic planet mass constraints would help to clarify whether this is actually the case, which might indicate that perturbers are not the only way of creating substructures

A multiwavelength analysis of the spiral arms in the protoplanetary disk around WaOph 6

Context. In recent years, protoplanetary disks with spiral structures have been detected in scattered light, millimeter continuum, and CO gas emission. The mechanisms causing these structures are still under debate. A popular scenario to drive the spiral arms is the one of a planet perturbing the material in the disk. However, if the disk is massive, gravitational instability isusually the favored explanation. Multiwavelength studies could be helpful to distinguish between the two scenarios. So far, only a handful of disks with spiral arms have been observed in both scattered light and millimeter continuum. Aims. We aim to perform an in-depth characterization of the protoplanetary disk morphology around WaOph 6 analyzing data obtained at different wavelengths, as well as to investigate the origin of the spiral features in the disk. Methods. We present the first near-infrared polarimetric observations of WaOph 6 obtained with SPHERE at the VLT and compare them to archival millimeter continuum ALMA observations. We traced the spiral features in both data sets and estimated the respective pitch angles. We discuss the different scenarios that can give rise to the spiral arms in WaOph 6. We tested the planetary perturber hypothesis by performing hydrodynamical and radiative transfer simulations to compare them with scattered light and millimeter continuum observations. Results. We confirm that the spiral structure is present in our polarized scattered light H-band observationsof WaOph 6, making it the youngest disk with spiral arms detected at these wavelengths. From the comparison to the millimeter ALMA-DSHARP observations, we confirm that the disk is flared. We explore the possibility of a massive planetary perturber driving the spiral arms by running hydrodynamical and radiative transfer simulations, and we find that a planet of minimum 10 MJup outside of the observed spiral structure is able to drive spiral arms that resemble the ones in the observations. We derive detection limits from our SPHERE observations and get estimates of the planet’s contrast from different evolutionary models. Conclusions. Up to now, no spiral arms had been observed in scattered light in disks around K and/or M stars with ages <1 Myr. Future observations of WaOph 6 could allow us to test theoretical predictions for planet evolutionary models, as well as give us more insightinto the mechanisms driving the spiral arms