MedStar Authors catalog › Details for: Predictors of Surgical Intervention in Dialysis Patients With Infective Endocarditis.
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Predictors of Surgical Intervention in Dialysis Patients With Infective Endocarditis.

by Thourani, Vinod H.
Citation: Open Forum Infectious Diseases. 5(11):ofy265, 2018 Nov..Journal: Open forum infectious diseases.Published: ; 2018ISSN: 2328-8957.Full author list: Woller Iii JA; Walsh VL; Robichaux C; Thourani VH; Jacob JT.UI/PMID: 30539033.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: (Click here) Abbreviated citation: Open forum infect. dis.. 5(11):ofy265, 2018 Nov.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.Abstract: 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.Abstract: 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.Abstract: Conclusions: Among ESRD patients with IE, most surgical indications are not predictive of early surgery.

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