Simple scoring system to predict in-hospital mortality after surgery for infective endocarditis

BACKGROUND: Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis. METHODS AND RESULTS: Outcomes of 361 consecutive patients (mean age, 59.1\ub115.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in-hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty-six (15.5%) patients died postsurgery. BMI >27 kg/m2 (odds ratio [OR], 1.79; P=0.049), estimated glomerular filtration rate 55 mm Hg (OR, 1.78; P=0.032), and critical state (OR, 2.37; P=0.017) were independent predictors of in-hospital death. A scoring system was devised to predict in-hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734-0.822). The score performed better than 5 of 6 scoring systems for in-hospital death after cardiac surgery that were considered. CONCLUSIONS: A simple scoring system based on risk factors for in-hospital death was specifically created to predict mortality risk postsurgery in patients with IE

Analyse des déterminants de la durée de l'antibiothérapie dans les prostatites bactériennes

REIMS-BU Santé (514542104) / SudocSudocFranceF

Etude descriptive de l'efficacité et de la tolérance du traitement par pristinamycine dans les infections sur prothèses articulaires : à propos de 24 patients suivis dans le service de maladies infectieuses du CHU de Reims

REIMS-BU Santé (514542104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Septicémie à streptocoque B de l'adulte : étude descriptive de 21 cas hospitalisés dans le service de médecine Interne et maladies infectieuses du CHU de Reims

REIMS-BU Santé (514542104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Epidémiologie descriptive des infections sur matériel étranger orthopédique à staphylocoques à coagulase négative méticillino-résistants en 2010-2011 et étude de l'impact de la CMI des glycopeptides

REIMS-BU Santé (514542104) / SudocSudocFranceF

VALEUR DIAGNOSTIQUE DES SIGNES DE LA MALADIE DE HORTON (ANALYSE DE 415 BIOPSIES D'ARTERES TEMPORALES)

REIMS-BU Santé (514542104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Les infections ostéo-articulaires à Propionibacterium acnes avec ou sans matériel étranger : à propos de 36 cas et revue de la littérature

REIMS-BU Santé (514542104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Leptospirose et fièvre hémorragique avec syndrome rénal à virus Puumana en Champagne-Ardenne entre 1995 et 2005 : comparaison des tableaux cliniques, biologiques et épidémiologiques

REIMS-BU Santé (514542104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Prognostic factors associated with 30-day in-hospital mortality in coagulase-negative Staphylococcus bacteraemia: no impact of vancomycin minimum inhibitory concentration

International audienc

Early antiviral treatment fails to completely prevent herpes-related pain

International audienceObjectives. - Antiviral therapy does not completely relieve herpes zoster (HZ)-related pain, including post-herpetic neuralgia (PHN). The 12-month longitudinal prospective observational ARIZONA study was conducted in primary care in France between November 20, 2006 and September 12, 2008. The ARIZONA study included data from 1358 patients 50 years of age or more, presenting with acute eruptive HZ. This article focuses on the relationship between antiviral therapy and HZ-related pain in this large population.Patients and methods. - Six hundred and forty-four family physicians (FPs) consecutively included all patients 50 years of age or more presenting with acute HZ in the eruptive phase. The FP documented every patient's demographic and medical characteristics, HZ characteristics, and prescribed drugs at inclusion, and the presence of HZ-related pain on day 15 and at months 1, 3, 6, 9, and 12.Results. - One thousand two hundred and fifty-eight (92.6%) of the 1358 included patients (mean 67.7 years [SD 10.7]; 62.2% female patients) were given antiviral drugs. The prevalence of HZ-related pain was 43.6%, 27.0%, 11.7%, 8.7%, 7.4%, and 6.0%, on day 15 and at months 1, 3, 6, 9, and 12, respectively. HZ-related pain was at least as frequent in patients treated by antiviral therapy within 72 hours following HZ-rash onset as in patients treated later or who did not receive antiviral treatment, and more frequent in patients whose diagnosis was made within 24 hours following HZ-rash onset.Conclusions. - Antiviral therapy, even early, does not prevent HZ-related pain and PHN, probably because patients quickly identified and treated were those with severe forms and potentially at high risk of pain. Preventive strategies are thus needed