Journal Article

Long-Term Outcome of Infective Endocarditis: The Impact of Early Surgical Intervention

Jihad Bishara, Leonard Leibovici, Dina Gartman Israel, Alex Sagie, Arkadi Kazakov, Eugeni Miroshnik, Shai Ashkenazi and Silvio Pitlik

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 10, pages 1636-1643
Published in print November 2001 | ISSN: 1058-4838
Published online November 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/323785
Long-Term Outcome of Infective Endocarditis: The Impact of Early Surgical Intervention

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To determine the impact of early surgical intervention on long-term survival in patients with infective endocarditis (IE), charts of all patients who had IE from January 1987 through December 1996 were reviewed. A total of 252 patients with definite or possible IE were included. Forty-four patients (17.5%) had early surgery on median hospital day 2 (range, 0–30 days), and 208 patients (82.5%) received medical treatment alone. On multivariate analysis, several variables, including early surgical intervention, improved long-term survival rates (hazard ratio, 1.5; P = .03), mainly in patients with Staphylococcus aureus etiology (P = .04). When patients with prosthetic devices were excluded, the median duration of survival for patients who had early surgery was >150 months, compared with 61.5 months for patients in the medical group (P = .1). Early surgical intervention compared with medical therapy alone is associated with increased short- and long-term survival rates in patients with IE, primarily when IE is caused by S. aureus.

Journal Article.  3416 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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