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Multicenter Study
. 2016 Apr;109(4):260-7.
doi: 10.1016/j.acvd.2015.11.012. Epub 2016 Feb 15.

Long-term prognosis of left-sided native-valve Staphylococcus aureus endocarditis

Layal Abdallah  1 , Jean-Paul Remadi  1 , Gilbert Habib  2 , Erwan Salaun  2 , Jean-Paul Casalta  2 , Christophe Tribouilloy  3
Affiliations
Free article
Multicenter Study

Long-term prognosis of left-sided native-valve Staphylococcus aureus endocarditis

Layal Abdallah et al. Arch Cardiovasc Dis. 2016 Apr.
Free article

Abstract

Background: Staphylococcus aureus infective endocarditis (SAIE) is a serious and common disease.

Aims: To assess the clinical and echocardiographic characteristics and prognostic factors of left-sided native-valve SAIE, and to compare these characteristics between two periods (1990-2000 vs. 2001-2010).

Methods: This was a retrospective analysis of 162 cases of left-sided native-valve SAIE among 1254 patients hospitalized for infective endocarditis (IE) between 1990 and 2010.

Results: SAIE represented 18.1% of all cases of IE and 22.9% of cases of native-valve IE. Complications included heart failure in 44.7% of cases, acute renal failure in 23.3%, sepsis in 28.5%, neurological events in 35.8%, systemic embolic events in 54.9% and in-hospital mortality in 25.3%. Factors associated with in-hospital mortality were heart failure (odds ratio [OR] 2.5; P=0.04) and sepsis (OR 5.3; P=0.001). Long-term 5-year survival was 49.6±4.9%. Factors associated with long-term mortality were heart failure (OR 1.7; P=0.032), sepsis (OR 3; P=0.0001) and delayed surgery (OR 0.43; P=0.003). Comparison of the two periods revealed a significant increase in bivalvular involvement, valvular incompetence and acute renal failure from 2001 to 2010. No significant difference was observed in terms of in-hospital mortality rates (28.1% vs. 23.5%; P=0.58) and long-term 5-year survival (45.0±6.6% vs. 57.1±6.4%; P=0.33).

Conclusion: Mortality as a result of left-sided native-valve SAIE remains high. Factors associated with in-hospital mortality are heart failure and sepsis. Factors associated with long-term mortality are heart failure, sepsis and delayed surgery. Despite progress in surgical techniques, in-hospital mortality and long-term mortality have not decreased significantly between the two periods.

Keywords: Endocardite infectieuse; Infective endocarditis; Left-sided native valve; Prognosis; Pronostic; Staphylococcus aureus; Valves natives gauches; Évolution.

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