title: Survival of surgically treated infective endocarditis: a comparison with the general Dutch population.
abstract: BACKGROUND
  Infective endocarditis (IE) remains associated with high in-hospital and long-term mortality. The outcome of patients with IE who are operated on has never been put into perspective by comparing it to the age-matched and gender-matched general population. The aim of the present study was to evaluate the long-term mortality of patients with IE who undergo operation in relation to the age-matched and gender-matched general population.
  
  
  METHODS
  A retrospective observational cohort study of 138 patients with IE who underwent consecutive operations (1998-2007) was conducted. Cumulative survival was analyzed using the Kaplan-Meier method. Comparison of patient survival with the general population was done using the Dutch population life table. The standardized mortality ratio was used to assess the degree of late deaths.
  
  
  RESULTS
  The observed in-hospital mortality risk was 10.9%. The observed long-term survival was 85% (95% confidence interval, 78% to 90%), 74% (95% confidence interval, 65% to 79%), 71% (95% confidence interval, 62% to 78%) after 1, 5, and 10 years, respectively. Age-matched and gender-matched survival in the general population was 99%, 93%, and 80% after a follow-up period of 1, 5, and 10 years, respectively. The standardized mortality ratio was 0.99 (95% confidence interval, 0.67 to 1.31).
  
  
  CONCLUSIONS
  Although mortality of IE patients who have undergone operation remains considerable during the immediate postoperative period, the mortality of hospital survivors is, with increasing follow-up time, comparable with the general population.
authors.affiliation: Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. m.mokhles@erasmusmc.nl
authors.forename: M Mostafa
authors.initials: MM
authors.lastname: Mokhles
authors.forename: Isabella
authors.initials: I
authors.lastname: Ciampichetti
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Head
authors.forename: Johanna J M
authors.initials: JJ
authors.lastname: Takkenberg
authors.forename: Ad J J C
authors.initials: AJ
authors.lastname: Bogers
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality*; D016022:Case-Control Studies; D002423:Cause of Death; D016001:Confidence Intervals; D004696:Endocarditis / Q000382:microbiology / Q000401:mortality* / Q000601:surgery*; D004697:Endocarditis, Bacterial / Q000382:microbiology / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors