Introduction: Infective endocarditis (IE) is a severe and fatal infection with high in-hospital and overall mortality rates of approximately up to 30%. Valve culture positivity was associated with in-hospital mortality and postoperative complications; however, few studies have analyzed the relationship between valve cultures and overall mortality over a long observation period. This study aimed to compare the association of valve culture positivity with overall mortality in patients with IE who underwent valve surgery. Methods: A total of 416 IE patients admitted to a tertiary hospital in South Korea from November 2005 to August 2017 were retrospectively reviewed. A total of 202 IE patients who underwent valve surgery and valve culture were enrolled. The primary endpoint was long-term overall mortality. Kaplan–Meier curve and Cox proportional hazards model were used for survival analysis. Results: The median follow-up duration was 63 (interquartile range, 38–104) months. Valve cultures were positive in 22 (10.9%) patients. The overall mortality rate was 15.8% (32/202) and was significantly higher in valve culture-positive patients (36.4%, p = 0.011). Positive valve culture [hazard ratio (HR) 3.921, p = 0.002], Charlson Comorbidity Index (HR 1.181, p = 0.004), Coagulase-negative staphylococci (HR 4.233, p = 0.001), new-onset central nervous system complications (HR 3.689, p < 0.001), and new-onset heart failure (HR 4.331, p = 0.001) were significant risk factors for overall mortality. Conclusions: Valve culture positivity is a significant risk factor for long-term overall mortality in IE patients who underwent valve surgery. The importance of valve culture positivity needs to be re-evaluated, as the valve culture positivity rate increases with increasing early surgical intervention.
|Number of pages||13|
|Journal||Infectious Diseases and Therapy|
|Publication status||Published - 2022 Jun|
Bibliographical noteFunding Information:
This study and the Rapid Service Fee were supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2022R1C1C1010012).
This study and the Rapid Service Fee were supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2022R1C1C1010012). All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Jinnam Kim, Jung Ho Kim, Hi Jae Lee, Nam Su Ku, Seung Hyun Lee made substantial contributions to study concept and design; data collection; data analysis; data interpretation; drafting of the manuscript; critical revision of the manuscript. All the other authors made substantial contributions to study design, data collection and critical revision of the manuscript for important intellectual content. All authors read and approved the final manuscript. Jinnam Kim, Jung Ho Kim, Hi Jae Lee, Se Ju Lee, Ki Hyun Lee, Eun Hwa Lee, Yae Jee Baek, Jin Young Ahn, Su Jin Jeong, Nam Su Ku, Seung Hyun Lee, Jun Yong Choi, Joon-Sup Yeom declare that they have no conflict of interest. This study was approved by the institutional review boards (IRBs) of Yonsei University College of Medicine (IRB no. 4-2018-0248). Informed consent was waived due to the retrospective nature of the study, which complied with the Good Clinical Practice guidelines and the Declaration of Helsinki. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
© 2022, The Author(s).
All Science Journal Classification (ASJC) codes
- Microbiology (medical)
- Infectious Diseases