Surgical treatment of patients with infective endocarditis: changes in temporal use, patient characteristics, and mortality—a nationwide study
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Surgical treatment of patients with infective endocarditis : changes in temporal use, patient characteristics, and mortality—a nationwide study. / Jensen, Andreas Dalsgaard; Østergaard, Lauge; Petersen, Jeppe K.; Graversen, Peter; Butt, Jawad H.; Bundgaard, Henning; Moser, Claus; Smerup, Morten H.; Modrau, Ivy S.; Iversen, Kasper; Bruun, Niels E.; Torp-Pedersen, Christian; Gislason, Gunnar; Wang, Andrew; Ragnarsson, Sigurdur; Povlsen, Jonas A.; Køber, Lars; Fosbøl, Emil L.
In: BMC Cardiovascular Disorders, Vol. 22, 338, 2022.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Surgical treatment of patients with infective endocarditis
T2 - changes in temporal use, patient characteristics, and mortality—a nationwide study
AU - Jensen, Andreas Dalsgaard
AU - Østergaard, Lauge
AU - Petersen, Jeppe K.
AU - Graversen, Peter
AU - Butt, Jawad H.
AU - Bundgaard, Henning
AU - Moser, Claus
AU - Smerup, Morten H.
AU - Modrau, Ivy S.
AU - Iversen, Kasper
AU - Bruun, Niels E.
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar
AU - Wang, Andrew
AU - Ragnarsson, Sigurdur
AU - Povlsen, Jonas A.
AU - Køber, Lars
AU - Fosbøl, Emil L.
N1 - Publisher Copyright: © 2022, The Author(s).
PY - 2022
Y1 - 2022
N2 - Background: Valve surgery guidelines for infective endocarditis (IE) are unchanged over decades and nationwide data about the use of valve surgery do not exist. Methods: We included patients with first-time IE (1999–2018) using Danish nationwide registries. Proportions of valve surgery were reported for calendar periods (1999–2003, 2004–2008, 2009–2013, 2014–2018). Comparing calendar periods in multivariable analyses, we computed likelihoods of valve surgery with logistic regression and rates of 30 day postoperative mortality with Cox regression. Results: We included 8804 patients with first-time IE; 1981 (22.5%) underwent surgery during admission, decreasing by calendar periods (N = 360 [24.4%], N = 483 [24.0%], N = 553 [23.5%], N = 585 [19.7%], P = < 0.001 for trend). For patients undergoing valve surgery, median age increased from 59.7 to 66.9 years (P ≤ 0.001) and the proportion of males increased from 67.8% to 72.6% (P = 0.008) from 1999–2003 to 2014–2018. Compared with 1999–2003, associated likelihoods of valve surgery were: Odds ratio (OR) = 1.14 (95% CI: 0.96–1.35), OR = 1.20 (95% CI: 1.02–1.42), and OR = 1.10 (95% CI: 0.93–1.29) in 2004–2008, 2009–2013, and 2014–2018, respectively. 30 day postoperative mortalities were: 12.7%, 12.8%, 6.9%, and 9.7% by calendar periods. Compared with 1999–2003, associated mortality rates were: Hazard ratio (HR) = 0.96 (95% CI: 0.65–1.41), HR = 0.43 (95% CI: 0.28–0.67), and HR = 0.55 (95% CI 0.37–0.83) in 2004–2008, 2009–2013, and 2014–2018, respectively. Conclusions: On a nationwide scale, 22.5% of patients with IE underwent valve surgery. Patient characteristics changed considerably and use of valve surgery decreased over time. The adjusted likelihood of valve surgery was similar between calendar periods with a trend towards an increase while rates of 30 day postoperative mortality decreased.
AB - Background: Valve surgery guidelines for infective endocarditis (IE) are unchanged over decades and nationwide data about the use of valve surgery do not exist. Methods: We included patients with first-time IE (1999–2018) using Danish nationwide registries. Proportions of valve surgery were reported for calendar periods (1999–2003, 2004–2008, 2009–2013, 2014–2018). Comparing calendar periods in multivariable analyses, we computed likelihoods of valve surgery with logistic regression and rates of 30 day postoperative mortality with Cox regression. Results: We included 8804 patients with first-time IE; 1981 (22.5%) underwent surgery during admission, decreasing by calendar periods (N = 360 [24.4%], N = 483 [24.0%], N = 553 [23.5%], N = 585 [19.7%], P = < 0.001 for trend). For patients undergoing valve surgery, median age increased from 59.7 to 66.9 years (P ≤ 0.001) and the proportion of males increased from 67.8% to 72.6% (P = 0.008) from 1999–2003 to 2014–2018. Compared with 1999–2003, associated likelihoods of valve surgery were: Odds ratio (OR) = 1.14 (95% CI: 0.96–1.35), OR = 1.20 (95% CI: 1.02–1.42), and OR = 1.10 (95% CI: 0.93–1.29) in 2004–2008, 2009–2013, and 2014–2018, respectively. 30 day postoperative mortalities were: 12.7%, 12.8%, 6.9%, and 9.7% by calendar periods. Compared with 1999–2003, associated mortality rates were: Hazard ratio (HR) = 0.96 (95% CI: 0.65–1.41), HR = 0.43 (95% CI: 0.28–0.67), and HR = 0.55 (95% CI 0.37–0.83) in 2004–2008, 2009–2013, and 2014–2018, respectively. Conclusions: On a nationwide scale, 22.5% of patients with IE underwent valve surgery. Patient characteristics changed considerably and use of valve surgery decreased over time. The adjusted likelihood of valve surgery was similar between calendar periods with a trend towards an increase while rates of 30 day postoperative mortality decreased.
KW - Cardiac valve surgery
KW - Epidemiology
KW - Infective endocarditis
KW - Temporal trend
U2 - 10.1186/s12872-022-02761-z
DO - 10.1186/s12872-022-02761-z
M3 - Journal article
C2 - 35906539
AN - SCOPUS:85135153084
VL - 22
JO - B M C Cardiovascular Disorders
JF - B M C Cardiovascular Disorders
SN - 1471-2261
M1 - 338
ER -
ID: 319805062