title: Risk factors predicting the postoperative outcome in 134 patients with active endocarditis.
abstract: BACKGROUND
  Surgery remains the cornerstone in management of endocarditis.
  
  
  METHODS
  In this retrospective cohort we evaluated the operative outcome of patients with infective endocarditis. The SPSS program was used to analyze the data.
  
  
  RESULTS
  A total of 134 predominantly male patients (60%) with a mean age of 55 ± 12.4 years were examined. The procedures included single valve (n = 88; 66%), double/multiple valves (n = 29; 22%), and valve-coronary artery bypass graft (CABG) (n = 16; 12%). Perioperative mortality was 11.9% (n = 16). In the multivariate analysis, dialysis (odds ratio [OR] = 7.88; 95% confidence interval [CI] [1.78-34.77]; P = .006), sepsis (OR = 19.5; 95% CI [2.76-137.9]; P = .002), and perfusion time (95% CI [1.00-1.02]; P = .003) were independent predictors of perioperative mortality. The overall long-term survival at 28 months was 69.2% ± 4%. Dialysis (P = .0001) was a predictor of mortality, whereas elevated creatinine in nondialysis patients (P = .0002) was not. In the multivariate analysis, dialysis (hazard ratio [HR] 4.06%; 95% CI [0.936-8.526]; P = .0002), CABG (HR 2.32; 95% CI [1.086-4.978]; P = .0299), chronic obstructive pulmonary disease (HR 2.20; 95% CI [1.027-4.739]; P = .0426), and double/multiple valve procedure (HR 3.0; 95% CI [1.467-6.206]; P = .0027) were risk factors for long-term mortality.
  
  
  CONCLUSIONS
  Renal failure but not renal insufficiency is a risk factor for short and long-term mortality.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Siyamek
authors.initials: S
authors.lastname: Neragi-Miandoab
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Edvard
authors.initials: E
authors.lastname: Skripochnik
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Michler
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: David
authors.initials: D
authors.lastname: D'Alessandro
mesh_terms: D058385:Cardiac Valve Annuloplasty / Q000401:mortality*; D015331:Cohort Studies; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000401:mortality*; D004696:Endocarditis / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011184:Postoperative Period; D011379:Prognosis; D051437:Renal Insufficiency / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome