title: Association between surgical indications, operative risk, and clinical outcome in infective endocarditis: a prospective study from the International Collaboration on Endocarditis.
abstract: BACKGROUND
  Use of surgery for the treatment of infective endocarditis (IE) as related to surgical indications and operative risk for mortality has not been well defined.
  
  
  RESULTS
  The International Collaboration on Endocarditis-PLUS (ICE-PLUS) is a prospective cohort of consecutively enrolled patients with definite IE from 29 centers in 16 countries. We included patients from ICE-PLUS with definite left-sided, non-cardiac device-related IE who were enrolled between September 1, 2008, and December 31, 2012. A total of 1296 patients with left-sided IE were included. Surgical treatment was performed in 57% of the overall cohort and in 76% of patients with a surgical indication. Reasons for nonsurgical treatment included poor prognosis (33.7%), hemodynamic instability (19.8%), death before surgery (23.3%), stroke (22.7%), and sepsis (21%). Among patients with a surgical indication, surgical treatment was independently associated with the presence of severe aortic regurgitation, abscess, embolization before surgical treatment, and transfer from an outside hospital. Variables associated with nonsurgical treatment were a history of moderate/severe liver disease, stroke before surgical decision, and Staphyloccus aureus etiology. The integration of surgical indication, Society of Thoracic Surgeons IE score, and use of surgery was associated with 6-month survival in IE.
  
  
  CONCLUSIONS
  Surgical decision making in IE is largely consistent with established guidelines, although nearly one quarter of patients with surgical indications do not undergo surgery. Operative risk assessment by Society of Thoracic Surgeons IE score provides prognostic information for survival beyond the operative period. S aureus IE was significantly associated with nonsurgical management.
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.). vivian.chu@duke.edu.
authors.forename: Vivian H
authors.initials: VH
authors.lastname: Chu
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Lawrence P
authors.initials: LP
authors.lastname: Park
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Eugene
authors.initials: E
authors.lastname: Athan
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Francois
authors.initials: F
authors.lastname: Delahaye
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Tomas
authors.initials: T
authors.lastname: Freiberger
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Cristiane
authors.initials: C
authors.lastname: Lamas
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Jose M
authors.initials: JM
authors.lastname: Miro
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Mudrick
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Jacob
authors.initials: J
authors.lastname: Strahilevitz
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Christophe
authors.initials: C
authors.lastname: Tribouilloy
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Emanuele
authors.initials: E
authors.lastname: Durante-Mangoni
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Juan M
authors.initials: JM
authors.lastname: Pericas
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Nuria
authors.initials: N
authors.lastname: Fernández-Hidalgo
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Francisco
authors.initials: F
authors.lastname: Nacinovich
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Hussien
authors.initials: H
authors.lastname: Rizk
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Vladimir
authors.initials: V
authors.lastname: Krajinovic
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Efthymia
authors.initials: E
authors.lastname: Giannitsioti
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: John P
authors.initials: JP
authors.lastname: Hurley
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Hannan
authors.affiliation: From Duke University Medical Center, Durham, NC (V.H.C., L.P.P., A.W.); Barwon Health and Deakin University, Geelong, Australia (E.A.); Hospital Louis Pradel, Lyon-Bron, France (F.D.); Center for Cardiovascular Surgery and Transplantation, Brno, and Central European Institute of Technology, Masaryk University, Brno, Czech Republic (T.F.); Instituto Nacional de Cardiologia, and Unigranrio, Rio de Janeiro, Brazil (C.L.); Infectious Diseases Service, Hospital Clinic-August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain (J.M.M., J.M.P.); OhioHealth Heart and Vascular Physicians, Columbus, OH (D.W.M.); Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J.S.); University Hospital, Amiens, and INSERM U-1088, University of Picardie, Amiens, France (C.T.); Internal Medicine, University of Naples SUN, Monaldi Hospital, Naples, Italy (E.D.-M.); Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (N.F.-H.); Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (F.N.); Cairo University Hospital, Cairo, Egypt (H.R.); University Hospital for Infectious Diseases, Zagreb, Croatia (V.K.); Attikon University General Hospital, Athens, Greece (E.G.); and Mater Misericordiae University Hospital, Dublin, Ireland (J.P.H., M.M.H.).
authors.forename: Andrew
authors.initials: A
authors.lastname: Wang
mesh_terms: D000038:Abscess / Q000453:epidemiology; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology; D015897:Comorbidity; D003428:Cross Infection / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D004617:Embolism / Q000209:etiology; D004696:Endocarditis / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000706:statistics & numerical data; D006351:Heart Valves / Q000382:microbiology / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents
keywords: endocarditis; infection; mortality; surgery; valve