Risk factor analysis of hospital mortality in patients with endocarditis with ring abscess.
BACKGROUND
Endocarditis associated with ring abscess is a pathology with high morbidity and mortality.


OBJECTIVE
The purpose of this study was to analyze hospital mortality risk factors in patients with ring abscess due to endocarditis.


METHODS
From January 1982 to December 2000, 104 patients underwent surgical intervention at the Heart Institute of the University of São Paulo Medical School for valve endocarditis with ring abscess. The age ranged from 6 years to 73 years, with an average of 40.3 years and 72.1% were male. According to NYHA functional class (FC), 12 (11.5%) were in FC II, 62 (59.6%) in FC III, and 30 (28.9%) in FC IV. Seventy-seven (74.0%) patients had endocarditis on a bioprosthesis, 58 (55.8%) in the aortic position and 19 (18.3%) in the mitral position. Twenty-nine (26.9%) patients had atrioventricular blockage prior to the operation. Univariate analysis was performed comparing variables and hospital mortality with a level of significance of 5%. Multivariate analysis was performed by logistic regression.


RESULTS
The hospital mortality was 19.2% (20 patients). Univariate analysis showed that atrioventricular blockage, age, and prosthetic valve endocarditis significantly influenced hospital mortality. Multivariate analysis identified atrioventricular blockage as an independent predictor of hospital mortality.


CONCLUSIONS
Preoperative atrioventricular blockage is an independent risk factor for hospital mortality in the surgical treatment of endocarditis with ring abscess.
Heart Institute, University of São Paulo Medical School, São Paulo, Brazil. dcipablo@incor.usp.br
Pablo Maria Alberto
PM
Pomerantzeff
Carlos Manuel
CM
de Almeida Brandão
João Marcelo
JM
Albuquerque
José Lima
JL
Oliveira
Altamiro Ribeiro
AR
Dias
Alfredo José
AJ
Mansur
Max
M
Grinberg
Sérgio Almeida
SA
de Oliveira
D000038:Abscess / Q000382:microbiology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000382:microbiology / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D002648:Child; D004697:Endocarditis, Bacterial / Q000401:mortality / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000382:microbiology*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000382:microbiology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors