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Author Notes:

Correspondence: J. A. Woller III, MD, 601 N. Caroline St, Baltimore, MD 21287: jwoller1@jhmi.edu

Rachel Powell, MD, collected and compiled the data set spanning the years 1992–2012, which we supplemented to create our data.

Financial support: None of the authors have significant financial disclosures.

Potential conflicts of interest.: All authors: no reported conflicts of interest.

All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Subjects:

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Infectious Diseases
  • Microbiology
  • end-stage renal disease
  • infective endocarditis
  • patient selection
  • surgical indications
  • valve surgery
  • NATIVE VALVE ENDOCARDITIS
  • HEALTH-CARE PROFESSIONALS
  • ANTIMICROBIAL THERAPY
  • EARLY SURGERY
  • MORTALITY
  • DIAGNOSIS
  • OUTCOMES
  • IMPACT
  • RISK
  • COMPLICATIONS

Predictors of Surgical Intervention in Dialysis Patients With Infective Endocarditis

Tools:

Journal Title:

Open Forum Infectious Diseases

Volume:

Volume 5, Number 11

Publisher:

, Pages ofy265-ofy265

Type of Work:

Article | Final Publisher PDF

Abstract:

Background: The use of valve surgery for infective endocarditis (IE) in end-stage renal disease (ESRD) patients may be different than in the general population. We assessed predictors of early surgery in ESRD patients with IE. Methods: We conducted a retrospective cohort study among dialysis patients with left-sided IE between 2005 and 2015. Indications for surgery were based on current endocarditis guidelines. Patients were categorized as early valve replacement surgery or delayed/no surgery. We used logistic regression to determine independent predictors of early surgery. Results: Among 229 patients, 67 (29.3%) underwent early surgery. New congestive heart failure was the only high level of evidence indication independently associated with early surgery (odds ratio [OR], 12.1; 95% confidence interval [CI], 3.4-43.6). Transfer from outside hospital (OR, 5.4; 95% CI, 2.2-13.3), valve rupture (OR, 6.9; 95% CI, 2.6-17.9), coagulase-negative staphylococcus etiology (OR, 3.8; 95% CI, 1.4-10.6), and presence of any low level of evidence indication (OR, 5.9; 95% CI, 2.2-15.5) predicted early surgery. Preexisting valve disease (OR, 0.31; 95% CI, 0.12-0.82) and surgical contraindications (OR, 0.05; 95% CI, 0.005-0.4) predicted nonsurgical treatment. Conclusions: Among ESRD patients with IE, most surgical indications are not predictive of early surgery.

Copyright information:

© The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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