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- Title
Mortality and timing of surgery in the left-sided infective endocarditis: an Italian multicentre study.
- Authors
Cecchi, Enrico; Ciccone, Giovannino; Chirillo, Fabio; Imazio, Massimo; Cecconi, Moreno; Del Ponte, Stefano; Moreo, Antonella; Faggiano, Pompilio; Cialfi, Alessandro; Squeri, Angelo; Enia, Francesco; Forno, Davide; De Rosa, Francesco Giuseppe; Rinaldi, Mauro; Castiglione, Anna
- Abstract
RESULTS: Among the 502 patients included, 184 (36.7%) underwent early surgery. Of the remaining 318 patients, 138 underwent late surgery. The early surgery group had fewer patients with comorbidities and with enterococcus as the causative microorganism, but this group had more complicated cardiac conditions. No difference in mortality risk was estimated between the treatment groups including early surgery as time-dependent variables (adjusted hazard ratio = 0.95, 95% confidence interval 0.55-1.63), while a distorted and overestimated beneficial effect of surgery was estimated considering surgery as a non-time-dependent variable (adjusted hazard ratio 0.41, 95% confidence interval 0.25-0.70). CONCLUSIONS: Our study did not confirm a better overall survival in patients undergoing early surgery. However, even with the use of statistical techniques to control biases, we could not draw definitive conclusions that early surgery is not beneficial. Our results need to be assessed by randomized trials before any changes in clinical practice can be recommended.
- Publication
Interactive Cardiovascular & Thoracic Surgery, 2018, Vol 26, Issue 4, p602
- ISSN
1569-9293
- Publication type
Article
- DOI
10.1093/icvts/ivx394