4 research outputs found
Analyses comparatives des méthodes de survie et extensions d'un modèle régressif de survie relative (prise en compte de la non-proportionnalité des risques par des fonctions B-splines et développement d'une méthode d'analyse bayésienne)
AIX-MARSEILLE2-BU MĂ©d/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Skin Protection by Sunscreens Is Improved by Explicit Labeling and Providing Free Sunscreen
Risk of Embolism and Death in Infective Endocarditis: Prognostic Value of Echocardiography
Background—
The incidence of embolic events (EE) and death is still high in patients with infective endocarditis (IE), and data about predictors of these 2 major complications are conflicting. Moreover, the exact role of echocardiography in risk stratification is not well defined.
Methods and Results—
In a multicenter prospective European study, including 384 consecutive patients (aged 57±17 years) with definite IE according to Duke University criteria, we tested clinical, microbiological, and echocardiographic data as potential predictors of EE and 1-year mortality. Transesophageal echocardiography was performed in all patients. Embolism occurred before or after IE diagnosis (total-EE) in 131 patients (34.1%) and after initiation of antibiotic therapy (new-EE) in 28 patients (7.3%).
Staphylococcus aureus
and
Streptococcus bovis
were independently associated with total-EE, whereas vegetation length >10 mm and severe vegetation mobility were predictors of new-EE, even after adjustment for
S aureus
and
S bovis
. One-year mortality was 20.6%. In multivariable analysis, independently of the other predictors of death (age, female sex, creatinine serum >2 mg/L, moderate or severe congestive heart failure, and
S aureus
) and comorbidity, vegetation length >15 mm was a predictor of 1-year mortality (adjusted relative risk=1.8; 95% CI, 1.10 to 2.82;
P
=0.02).
Conclusions—
In IE, vegetation length is a strong predictor of new-EE and mortality. In combination with clinical and microbiological findings, echocardiography may identify high-risk patients who will need a more aggressive therapeutic strategy