Characteristics of patients with PVE according to in-hospital mortality.

Characteristics of patients with PVE according to in-hospital mortality.</p

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BackgroundProsthetic valve endocarditis (PVE) is a serious infection associated with high mortality that often requires surgical treatment.MethodsStudy on clinical characteristics and prognosis of a large contemporary prospective cohort of prosthetic valve endocarditis (PVE) that included patients diagnosed between January 2008 and December 2020. Univariate and multivariate analysis of factors associated with in-hospital mortality was performed.ResultsThe study included 1354 cases of PVE. The median age was 71 years with an interquartile range of 62–77 years and 66.9% of the cases were male. Patients diagnosed during the first year after valve implantation (early onset) were characterized by a higher proportion of cases due to coagulase-negative staphylococci and Candida and more perivalvular complications than patients detected after the first year (late onset). In-hospital mortality of PVE in this series was 32.6%; specifically, it was 35.4% in the period 2008–2013 and 29.9% in 2014–2020 (p = 0.031). Variables associated with in-hospital mortality were: Age-adjusted Charlson comorbidity index (OR: 1.15, 95% CI: 1.08–1.23), intracardiac abscess (OR:1.78, 95% CI:1.30–2.44), acute heart failure related to PVE (OR: 3. 11, 95% CI: 2.31–4.19), acute renal failure (OR: 3.11, 95% CI:1.14–2.09), septic shock (OR: 5.56, 95% CI:3.55–8.71), persistent bacteremia (OR: 1.85, 95% CI: 1.21–2.83) and surgery indicated but not performed (OR: 2.08, 95% CI: 1.49–2.89). In-hospital mortality in patients with surgical indication according to guidelines was 31.3% in operated patients and 51.3% in non-operated patients (pStaphylococcus aureus, septic shock, and stroke.ConclusionsNot performing cardiac surgery in patients with PVE and surgical indication, according to guidelines, has a significant negative effect on in-hospital mortality. Strategies to better discriminate patients who can benefit most from surgery would be desirable.</div

Characteristics of patients with native valve endocarditis compared patients with prosthetic valve endocarditis.

Characteristics of patients with native valve endocarditis compared patients with prosthetic valve endocarditis.</p

Characteristics of patients with PVE and surgical indication according to whether the patient underwent surgery.

Characteristics of patients with PVE and surgical indication according to whether the patient underwent surgery.</p

Multivariate analysis of clinical factors of PVE associated with in-hospital mortality.

Multivariate analysis of clinical factors of PVE associated with in-hospital mortality.</p

Multivariate analysis of clinical factors of PVE associated with in-hospital mortality without considering “septic shock”.

Multivariate analysis of clinical factors of PVE associated with in-hospital mortality without considering “septic shock”.</p

Survival of patient with PVE according to surgery performance.

Survival of patient with PVE according to surgery performance.</p

Flowchart of patients presenting with definite or possible infective endocarditis (IE) according to the type of affected valve (games cohort 2008–2020).

ICD: implantable cardioverter defibrillator. NVAG: non-valve aortic graft. TAVR: transcatheter aortic valve replacement. PVE: prosthetic valve endocarditis.</p

Additional file 1 of Dynamics of disease characteristics and clinical management of critically ill COVID-19 patients over the time course of the pandemic: an analysis of the prospective, international, multicentre RISC-19-ICU registry

Additional file 1. Online Supplementary Material